Medical Coordinator (Hybrid/Remote)

Job summary

The Medical Coordinator is responsible for the medical management of medium-risk claims, including reviewing medical records and assessing the appropriateness of treatments. They also assist with claim triage and document all actions taken within the case management software.

Job details

Job Description Are you a people person with a knack for providing excellent customer service? Are you interested in working in a multilingual and friendly environment that encourages personal and professional development? We would love to meet you! Global Excel Management works with Canadian, International Insurers and prestigious brands, provides services to individuals who have purchased a travel insurance policy and need assistance on their trip or to submit a claim. The Case Management team guides travelers around the globe through high acuity medical emergencies. As part of the Case Management team, the Medical Coordinator is responsible for medical management of medium-risk claims. This includes the prompt review, analysis and development of a case plan based on the understanding of what a clients’ travel policy covers, ensuring that medical expenses are appropriate and necessary. The Medical Coordinator will also assist with claim triage by assessing the medical risk of new claims and closing claims that do not meet case management criteria. What does your typical day look like? Review, summarize and analyze client medical records, with a focus in outpatient claims and some inpatient claims as needed; Assess the appropriateness of proposed medical treatment with the support of GEM Medical Directors/Medical Advisors; Formulate a case direction and communicate this to the team; Analyze clinical information and communicate the impact on eligibility for coverage to internal and external stakeholders; Use case management software to accurately and concisely document all call details and actions taken/required; Work with GEM Triage team in assessment of medical risk of incoming claims; Responsibilities may be adjusted to support alternate functions as business needs change; Hybrid work model post completion of orientation; Able to work various shifts and days of the week as required, primarily day shift with rotating evenings and weekends as required. What skills and training do you need? College Diploma/University Degree in Nursing or equivalency medical training; Current license in good standing with the respective provincial nursing governing body; At least one year of clinical experience in an acute care setting an asset; Handle/communicate and exchange sensitive and confidential information in a professional manner; Excellent written and verbal communication skills with proven ability to communicate medical terms/concepts to diverse groups, including medical professionals and the general public; Able to handle fluctuating work volumes in a fast paced, customer focused environment; Able to successfully work independently and in a team; Proven ability to prioritize work responsibilities to achieve best possible outcomes; Basic understanding of travel insurance, insurance terminology and case management is an asset; Strong computer skills (Microsoft System including word, excel, teams, outlook). Excellent communication skills in English. English will be used on a daily basis to communicate with business clients and insured members, the majority of whom are located outside of Quebec, to obtain missing information, follow up on files, and collaborate with colleagues and departments across our various offices, including Ontario, Miami, Mexico, and other locations. Additional language skills, particularly in French and/or Spanish, are considered an asset. When you apply: If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs. We offer you Global Excel offers more than a position; We offer a competitive compensation package that includes a base salary, performance bonus and an extensive benefits package; A professional future with opportunities for development, growth, and advancement; RRSP Match program; Financial assistance to employees who wish to continue their education; Work/life balance, health and wellness initiatives including an excellent EAP program; Employee engagement programs that focus on fitness, food, and fun. Ontario Candidates : Salary starting at 27.60$/hour. ​ Québec Candidates : Salary starting at 26.78$/hour. ​ To get a taste of the Global Excel life and for more information on our company, visit our Facebook page and website:

What you’ll do

The Medical Coordinator is responsible for the medical management of medium-risk claims, including reviewing medical records and assessing the appropriateness of treatments. They also assist with claim triage and document all actions taken within the case management software.

Requirements

Candidates must hold a college diploma or university degree in nursing or equivalent medical training with a current license. At least one year of clinical experience in an acute care setting is considered an asset.

Benefits

• Performance bonus
• Extensive benefits package
• RRSP match program
• Financial assistance for education
• Work/life balance
• Health and wellness initiatives
• Employee assistance program
• Employee engagement programs

Listed skills

• Customer service · Preferred
• Communication · Preferred
• Microsoft Office · Preferred
• Microsoft Teams · Preferred
• Microsoft Outlook · Preferred
• Critical Thinking · Preferred
• Time management · Preferred
• Teamwork · Preferred
• Problem solving · Preferred

Other relevant skills

Identified from the job description. Confirm important requirements above.

• Medical case management
• Clinical documentation
• Medical record analysis
• Claim triage
• Customer service
• Communication
• Microsoft Office
• Microsoft Teams
• Microsoft Outlook
• Risk assessment
• Insurance terminology
• Critical thinking
• Time management
• Teamwork
• Problem solving
• Financial Assistance
• Clinical Experience
• Professionalism
• Microsoft Excel
• Acute Care
• Multilingualism
• Management
• Case Management
• Law Practice Management Software
• Medical Records
• Customer Service
• Hospital Information Systems
• Computer Literacy
• Employee Assistance Programs
• Employee Engagement
• English Language
• Spanish Language
• French Language
• High Acuity Medicine
• Medical Management
• Medical Terminology
• Triage
• Verbal Communication Skills
• Prioritization

Job areas

• Healthcare
• Customer Service & Support
• Administrative
• Medical Coordinator
• Clinical Coordinator
• Health Service Managers
• Medical and Health Services Managers

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