Wanted: Claims Adjudicator

CLAIMS ADJUDICATOR

INGLE INTERNATIONAL

 

Who We Are:

Ingle International is a company that connects a diverse group of individuals and businesses with the customized insurance products, services, and information they need for safe and healthy travels. It provides innovative travel insurance products to affinity groups, rewards programs and organizations and delivers superior customer care with highly trained, multilingual staff serving the needs of travellers going anywhere in the world. Our expertise can be credited to a company culture deeply rooted in technology. Ingle fosters a challenging work environment, but also a fun, friendly, and cooperative one. We also offer a competitive compensation package and comprehensive benefits package including life, health, dental, and vision, a generous wellness bursary, tuition reimbursement, and business casual dress. Ingle is an equal opportunity employer and welcomes and encourages applications from people with disabilities. Accommodations are available on request for candidates taking part in all aspects of the selection process.

 

Who You Are:

You are an experienced claims adjudicator who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced environment providing excellent customer service in both the turnaround of the claim and handling emails and incoming calls.  You will have the desire to develop an in-depth understanding of this position and be able to easily maneuver through numerous policies to accurately assess claims.  You are a very strong team player.

 

The Role:

The claims adjudicator will be responsible for processing a variety of different claims and communicating these decisions to providers, members, and clients. This role requires strong time management skills and claims expertise.

 

 

Responsibilities:

  • Process health, dental and vision claims
  • Adjudicate claims according to various benefit policies
  • Provide excellent customer service for claims matters both in person and via written correspondence
  • Help the Claims Team problem-solve and use sound judgment and discretion to proactively address and resolve problems
  • Work closely with Assistance Team, Finance Team and other teams on day-to-day operations
  • Ensure all work complies with the PIPEDA and HIPAA
  • Support department initiatives that increase revenues, save costs and meet company objectives
  • Participate in client implementations and projects where required
  • Act as an SME for all claims-related matters
  • Handle both inbound and outbound calls to members and health providers as required
  • Other related duties as assigned

 

Required Attributes:

  • Experience in the travel insurance industry is required
  • Minimum 3 years of relevant Canadian claims processing experience
  • Experience in processing health, dental and vision claims
  • High level of proficiency in Microsoft Office suites
  • Superior verbal and written communication skills
  • Strong time management and organizational skills
  • Strong analytical and problem solving skills
  • Knowledge working with excel

 

Assets:

  • Snowbird, expatriate insurance, TPA experience
  • Cost containment/provider relations experience
  • Experience with medical coding standards
  • Dispute resolutions experience
  • GHIP recovery/coordination of benefits/subrogation
  • Experience in handling US medical invoices/claims

Want to learn more about our company—or find out what other opportunities are available? Check out our blog.

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