Claim analyst
Job Description
<strong><u>About The Company</u></strong><p><br></p>A leader in the development and administration of custom-made group insurance plans and group pension plans, AGA ranks among Canada’s largest benefit providers. Our clients include small, medium and large businesses as well as financial security and group insurance advisors who offer group plans to their clients. AGA serves more than 2,600 clients across Canada with some 250 employees in our offices located in Montreal, Quebec City, Kitchener, Markham, Edmonton, Calgary, St. John (NB) and Vancouver. A business operating on a human scale, AGA Benefit Solutions provides a vibrant and innovative work environment along with exciting career opportunities.<p><br></p><strong><u>About The Job – Fully Remote</u></strong><p><br></p>Reporting to the Department Head – Claims, the Regular Claims Analyst will be mainly responsible for processing health and dental care claims, whether in digitized form or submitted online (Members Portal).<p><br></p>The incumbent is expected to:<p><br></p><ul><li> Validate documents required for claims processing: original receipts, dates, professionals in good standing, medical recommendations, student status, coordination, Bill 33, application of usual and customary fees, etc.; </li><li> Enter claims payment data in our computer system for health care and in TELUS for drugs and dental care; </li><li> Validate the eligibility of certain fees based on insurers’ procedures or internal practices; </li><li> Prepare requests for additional information so they can be forwarded to members or filed on the members’ portal; </li><li> Reconsider certain claims when there has been an error or omission; </li><li> Carry out daily management of claims outstanding for non-payment to ensure reimbursements will not be delayed once premiums are paid; </li><li> Communicate externally to obtain additional information required for claims processing (clinics, dentists, professionals, pharmacies, etc.); </li><li> Replace the clerk when absent or on vacation; </li><li> Perform any other related duties at the supervisor’s request. </li></ul><p><br></p>RequirementsThe ideal candidate will have the following qualifications:<p><br></p><ul><li> College Diploma or Diploma of Vocational Studies; </li><li> Minimum 2 years of relevant experience; </li><li> Knowledge of group insurance, medical, pharmaceutical or dental fields (an asset); </li><li> Attention to detail, thoroughness and commitment to deadlines; </li><li> Ability to protect confidential information; </li><li> Versatility, resourcefulness and ability to work independently; </li><li> Excellent command of English and French, written and spoken; </li><li> Good knowledge of Microsoft Office suite. </li></ul><p><br></p>BenefitsMonthly base salary:<p><br></p>1,200 to 1,500 EUR<p><br></p>
