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Insurance Medical Claims Examiner jobs

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    • Reviewing, examining, calculating, and making decisions on a variety of claims received in the claims processing unit, to ensure the claim is paid under the…
    • View all Source Code jobs - Cambridge jobs
    • Salary Search: Claims Examiner salaries in Cambridge, ON
    • Manage and deliver forensic accounting engagements focused on the quantification of insurance claims, primarily related to motor vehicle accidents.
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    • Detailed knowledge of the property insurance industry and strong solid understanding of property insurance case law.
    • In this role, you will be responsible for both the oversight and management of third party adjusted claims and direct handled claims.
    • Zurich Canada is currently looking for a Complex Claims Specialist to handle single and multi party claims of high exposure and complexity within specific…
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    • Has a keen understanding of medical terminology and medical abbreviations;
    • Collect and review medical documents and treatment plans; to quantify claims;
    • Reviews claim entitlement recommendations for creditor claim acceptance or denial and provide financial and process oversight for Examiners.
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    • Enquêter, évaluer et déterminer l’admissibilité au paiement initial et continu des demandes de règlement selon les renseignements médicaux, les exigences de…
    • 2+ years of Accident Benefits insurance claims handling experience is required required.
    • To appropriately handle Accident Benefits claims according to…
    • Document claims files by accurately capturing and updating claims data and information in compliance with best practices for low to moderate exposure and…
    • Et depuis plus de 90 ans, notre sens de l’innovation nous a permis de devancer l’évolution des besoins de notre clientèle.
    • Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
    • Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
    • Prior insurance experience and/or knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
    • Review insurance policy and coverages.
    • 1 - 3 years handling complex automobile claims is required.
    • Settle claims in accordance with organization’s policies and…
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Job Post Details

Claims Examiner - job post

Source Code
3.1 out of 5 stars
Cambridge, ON
Full-time

Job details

Job type

  • Full-time

Location

Cambridge, ON

Full job description

Claims Examiner/Adjuster

Cambridge, ON (On-site)

6-month contract

Review, examine, calculate and make decisions on a variety of claims in accordance with applicable policy and service standards. Required to attain performance objectives on a monthly basis.

  • Reviewing, examining, calculating, and making decisions on a variety of claims received in the claims processing unit, to ensure the claim is paid under the respective policy and within the contracted timeframes.
  • Conducting research via policies/flipcharts that can provide additional information needed to adjudicate claims.
  • Entering notes into the computer system/databases as required.
  • Facilitating stop payment requests and processing reissues accordingly.
  • Placing outbound calls to customers or providers to obtain information required to adjudicate a claim.
  • Creating and sending various types of professional correspondence.
  • Responding to inter-departmental inquiries.
  • Responding to escalations in a timely manner.

Qualifications:

  • Post-secondary education
  • Minimum of 6-12 months experience as a Claims Examiner or similar role.
  • Ability to pay close attention to detail and multi-task.
  • Possess sound judgment and good decision-making skills.
  • Fluency in French is preferred.

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