Title : CLAIMS ASSESSOR - Ministry of Health and Long-Term Care - Thunder Bay, ON
link : CLAIMS ASSESSOR - Ministry of Health and Long-Term Care - Thunder Bay, ON
CLAIMS ASSESSOR - Ministry of Health and Long-Term Care - Thunder Bay, ON
Organization:
Ministry of Health and Long-Term Care
Division:
Direct Services Division/Claims Services Branch
City:
Thunder Bay
Job Term:
1 Permanent
Job Code:
09OAD - Office Administration 09
Salary:
$24.15 - $28.15 Per Hour*
*Indicates the salary listed as per the OPSEU Collective Agreement.
*Indicates the salary listed as per the OPSEU Collective Agreement.
Open
Job ID:
112980
Your strong administration, research and analytical skills are in demand! In this exciting opportunity, the Ministry of Health and Long-Term Care is looking for someone with those very skills to join a dynamic team that provides excellence in processing medical claims for Ontarians.
• Use your research skills to assess and process medical claims and travel grants.
• Research records and information on databases.
• Analyze payment irregularities.
• Respond to inquiries and provide service to public, medical providers and third party agencies.
• Initiate payments, adjustments or recoveries.
• Deal with confidential and sensitive medical and personal information.
• Proven ability to understand, interpret and apply policies, work within guidelines, procedures and legislation to process claims and protect information.
• Ability to evaluate stakeholder claims.
• Ability to determine eligibility criteria and apply appropriate payment
• Proven ability to apply discretion and judgment to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.
• Ability to determine appropriate payment.
• Proven ability to apply discretion and judgment to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.
• Proven ability to provide exceptional customer service to stakeholders.
• Demonstrated interpersonal skills to interact with clients and team members and to understand and respond appropriately to issues, dealing with conflict situations and/or with sensitive medical/financial information.
• Demonstrated experience to meet deadlines and organization goals and assist in the training of new and existing employees.
• Demonstrated organizational skills to organize and manage own work, take direction when required and work cooperatively as a team.
• Working knowledge of personal computers, mainframe applications, software (e-mail, word processing, internet, databases)
• Demonstrated keyboarding skills to input/access/retrieve information and create correspondence and reports
What can I expect to do in this role?
You will:• Use your research skills to assess and process medical claims and travel grants.
• Research records and information on databases.
• Analyze payment irregularities.
• Respond to inquiries and provide service to public, medical providers and third party agencies.
• Initiate payments, adjustments or recoveries.
• Deal with confidential and sensitive medical and personal information.
How do I qualify?
KNOWLEDGE:
• Demonstrated knowledge of data entry/keyboarding to process a high volume of medical claims.• Proven ability to understand, interpret and apply policies, work within guidelines, procedures and legislation to process claims and protect information.
• Ability to evaluate stakeholder claims.
• Ability to determine eligibility criteria and apply appropriate payment
• Proven ability to apply discretion and judgment to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.
RESEARCH AND ANALYTICAL SKILLS:
• Ability to evaluate and adjudicate stakeholder claims.• Ability to determine appropriate payment.
• Proven ability to apply discretion and judgment to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.
ORGANIZATIONAL SKILLS:
• Ability to organize and manage own workload, process a high volume of claims and inquiries within strict timeframes.TACT, DIPLOMACY AND COMMUNICATION SKILLS:
• Demonstrated ability to provide detailed and understandable explanations (oral and written) on work processes and claims payments to internal and external clients.• Proven ability to provide exceptional customer service to stakeholders.
• Demonstrated interpersonal skills to interact with clients and team members and to understand and respond appropriately to issues, dealing with conflict situations and/or with sensitive medical/financial information.
• Demonstrated experience to meet deadlines and organization goals and assist in the training of new and existing employees.
• Demonstrated organizational skills to organize and manage own work, take direction when required and work cooperatively as a team.
MATHEMATICAL AND COMPUTER SKILLS:
• Ability to calculate fees, reconcile payments and adjustments.• Working knowledge of personal computers, mainframe applications, software (e-mail, word processing, internet, databases)
• Demonstrated keyboarding skills to input/access/retrieve information and create correspondence and reports
Additional Information:
Address:
- 1 Permanent, 435 South James St, Thunder Bay, North Region, General Screening Requirement
Compensation Group:
Ontario Public Service Employees Union
3.7
Category:
Administrative and Support Services
Posted on:
Wednesday, January 3, 2018
Note:
- In accordance with the Ontario Public Service Employment Screening Checks Policy, the top candidate(s) may be required to undergo a security screening check. Please refer to the Additional Information / Address section above to determine the screening checks that are required for this position.
You will be responsible for obtaining the criminal record check at your own expense and provide it, along with your written consent, to the Transition and Security Office (TSO), HR Service Delivery Division to evaluate the results. If applicable, the TSO, with your written consent, will request and obtain any additional screening checks as indicated in the Additional Information / Address section above that were not obtained directly by you. (Note: If a Vulnerable Sector Screening/Check is required, it must also be obtained in person at your local police service.)
A record under the Criminal Code and/or other federal offence record(s) does not automatically mean you will be ineligible for the position. The screening check(s) will only be reviewed and evaluated by the TSO for the purpose of making a security clearance decision. The details of an individual's screening check(s) will be considered in specific relation to the duties and responsibilities of the position being filled. Screening check records will be maintained by the TSO and kept strictly confidential. - N-HL-112980/17
How to apply:
- You must apply online.
- Your cover letter and resume combined should not exceed five (5) pages. For tips and tools on how to write a concise cover letter and resume, review the Writing a Cover Letter and Resume: Tips, Tools and Resources.
- Customize your cover letter and resume to the qualifications listed on the job ad. Using concrete examples, you must show how you demonstrated the requirements for this job. We rely on the information you provide to us.
- Read the job description to make sure you understand this job.
- OPS employees are required to quote their WIN EMPLOYEE ID number when applying.
- If you require a disability related accommodation in order to participate in the recruitment process, please Contact Us to provide your contact information. Recruitment Services staff will contact you within 48 hours.
Please be advised that the results of this competition may be used to form an eligibility list of qualified candidates to potentially fill future vacancies represented by the Ontario Public Service Employees Union (OPSEU). In accordance with the Collective Agreement, eligibility lists are shared with OPSEU representatives. By applying to this competition, you are providing consent that your name may be shared with OPSEU representatives.
All external applicants (including former employees of the Ontario Public Service) applying to a competition in a ministry or Commission public body must disclose (either in the cover letter or resume) previous employment with the Ontario Public Service. Disclosure must include positions held, dates of employment and any active restrictions as applicable from being rehired by the Ontario Public Service. Active restrictions can include time and/or ministry-specific restrictions currently in force, and may preclude a former employee from being offered a position with the Ontario Public Service for a specific time period (e.g. one year), or from being offered a position with a specific ministry (either for a pre-determined time period or indefinitely). The circumstances around an employee's exit will be considered prior to an offer of employment.
Remember: The deadline to apply is Wednesday, January 17, 2018 11:59 pm EST. Late applications will not be accepted.
We thank you for your interest. Only those selected for further screening or an interview will be contacted.
We thank you for your interest. Only those selected for further screening or an interview will be contacted.
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