Medical Adjudication jobs in Ontario

First Canadian Health Management Corporation (FCH) is a 100% Indigenous owned and operated company, providing Indigenous staffing on health services to Indigenous People. We are hiring a Customer Service Representative, ideally Indigenous, who is passionate to work for an Indigenous company. Our employees work on NIHB (Non- Insured Health Benefits) Program and are a direct support to the Indigenous communities through providing excellent customer service. This employment opportunity is targeted to the individual who is Indigenous and understands the culture to provide compassion and service excellence to the community and health care providers. Hybrid work available.

Description:

First Canadian Health is looking for Bilingual Customer Service Representative to work within our inbound Provider Call Centre. The ideal candidate must be able to work up to 35 hours per week and be flexible working afternoons and evenings, as well as occasional weekends and holidays.

The Provider Call Centre is the main venue for communication between providers, clients and members and First Canadian Health regarding day-to-day claims adjudication queries and coverage inquiries. The Customer Service Representatives reflect First Canadian Health’s commitment to accessibility and responsiveness to all callers who require support-. This position is instrumental in meeting contractual objectives and service levels.

Preferential hiring is given to candidates of Indigenous ancestry including status and non-status First Nations, Metis and Inuit. We encourage applicants to include this information in their cover letter when applying.

Key Responsibilities:

• Respond to inbound calls from a variety of Health Care Providers
• Respond to inquiries regarding eligibility of health care benefits (Dental, Pharmacy, Medical Supplies and Equipment, Extended Health, Vision Care and Mental Health Counselling) and claim inquiries to providers, members and clients
• Identify and assess the caller’s needs to provide resolution
• Provide accurate, and complete information in a prompt and professional manner
• Provide technical support where required to assist providers with electronic claims submissions
• Collaborate with other internal teams & departments
• Communicate effectively and efficiently
• Provide a world-class customer service experience with every interaction
• Other duties as assigned

Please note this role requires flexible availability and may include weekend shifts. The Call Centre hours are Monday to Friday, 6:30am to midnight and weekends and holidays, 8:00am to midnight.

Qualifications:

• A minimum of 1 year of prior experience in a call center or customer service role
• Excellent verbal and written communication skills
• Strong interpersonal skills with the ability to work independently and within a team environment
• Problem-solving skills
• Flexibility in working days, evenings and holidays
• Skilled in MS Office (Word, Excel, Outlook), along with strong keyboarding skills
• Bilingualism, English and French, is required

Physical Demands/Working Conditions:

• Must clear Public Works enhanced security clearance screening
• Job requires precise finger/hand movements while working with a keyboard
• Need to remain at work station for lengthy periods
• Must be flexible to work shifts; including days, afternoons, evenings – 6:30 a.m. to midnight, weekends and holidays 8:00 a.m. to midnight

Benefits of Working with FCH:

• Pension and Group Benefits start on first day of employment
• Competitive salary with generous PTO
• Inclusive work environment

We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.

Job Types: Full-time, Permanent

Pay: From $39,000.00 per year

Ability to commute/relocate:

• Toronto, ON M4N 3N1: reliably commute or plan to relocate before starting work (required)

Application question(s):

• There is a bona fide requirement of being granted security clearance through the Government of Canada for this position. Can you meet all of the following security clearance requirements: At least 18 years of age, Lived in Canada for the past 5 years, Able to clear a criminal record check
• Preferential hiring is given to Indigenous candidates for this position, though it is not a requirement. Do you identify as an Indigenous person in Canada?
• Do you have any Customer Service experience, or skills from past employment that you feel would be useful for the position?

Language:

• French (required)

Work Location: Hybrid remote in Toronto, ON M4N 3N1