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Claims Administrator (Term)

People Corporationabout 24 hours ago
Toronto, ON
Mid Level
full_time
contract

About the role

The Claims Administrator (Term) organizes and prepares claims for submission to the designated adjudication provider, ensuring timely and accurate processing. They also serve as the first point of contact for member inquiries, offering clear and helpful information regarding claim status and benefit coverage. This is a fixed-term position through the end of September 2025.

The Claims Administrator (Term) will:

  • Reports to Benefits Administration Manager and receives work direction from them.
  • Reviews, examines and directs the processing of unusual or complex claim cases or claims to service provider.
  • Investigates any issues with claims Adjudication and reports to the manager the complete findings.
  • Regularly review and update the Claims manual.
  • Correspond and communicate via telephone, written correspondence, or face-to-face with members, providers, consultants, or other internal or external customers.
  • Apply guidelines, determine coverage, complete eligibility verification, and identify discrepancies
  • Any other duties delegated by the Benefits Administration Manager.

Key Contacts/Relationships External and Internal:

  • Communicates with other departments and managers/supervisors.
  • Deals directly with Plan participants/members and their dependents and beneficiaries by phone, fax, email, mail, or in person.
  • Corresponds with insurance providers, consultants, and Union Representatives with regard to specific claims submitted.

To be successful as a Claims Administrator (Term) with McAteer, you will need:

  • Minimum 3-5 years work experience in an office environment
  • Strong verbal and written communication skills (in both French and English)
  • The ability or past knowledge of interpreting Benefit Plans with the ability to apply all guidelines of each in the day-to-day workflow.
  • Familiarity with contract wording, policy provisions, and the Insurance Act.
  • Analytical skills needed to research, review and assess claims
  • Familiarity with contract wording, policy provisions and the Insurance Act
  • Excellent organizational skills.
  • Excellent attention to detail.
  • Excellent work ethic and accountability.
  • Ability to manage priorities and reporting timelines.
  • Strong verbal and written communication skills;
  • Strong attention to detail with exceptional organization skills;
  • Ability to manage multiple cases simultaneously
  • Excellent computer skills, including MS Office applications, with strong skills in MS Excel.
  • Co-operative team player with strong math and analytical skills.
  • Skill in performing detailed numerical computations.
  • The ability to closely analyze and focus on detailed reporting and investigate discrepancies.

What’s in it for you:

  • Learn by working alongside our experts
  • Assistance for the completion of industry designations
  • Competitive compensation

McAteer provides third-party advisory and administration services for over 200,000 plan members and beneficiaries. We are authorized claims payors for several major insurance companies; we provide administration services to plans that are local, provincial, and national in scope.

Providing an inclusive, accessible environment, where all employees and clients feel valued, respected and supported is something we’re committed to. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. If you require an accommodation or an alternative format of any posting please reach out to careers@peoplecorporation.com.

About People Corporation

Insurance
1001-5000

At People Corporation®, we are making a difference in the lives of more than one million Canadian employees and their families by providing employee group benefits, group retirement, wellness, and human resource solutions.

People Corporation is dedicated to helping businesses succeed. With offices and partner firms across the country, we offer expertise in your local market, while being supported by the resources of one of Canada’s fastest growing companies.

We specialize in:

Group Benefits Consulting and Advisory Services Third Party Administration Customized Billing and Reporting Sustainable Solutions Cost Containment Benchmarking Multiple Funding Arrangements Integrating Several Carrier Solutions into a Single Solution Preferred Supplier and Pharmacy Networks Disability Management Health Spending Accounts Wellness Solutions Value-Added Programs Best-in-Class Service Support backed by our Concierge Service Program

Our diverse team of experts provide industry-specific insight, and offer customized solutions designed to fit the unique needs of your business and your most valuable asset – your people. Visit peoplecorporation.com to experience the benefits of people.