Reports to
Manager, Health Claims
Location
Waterloo, Ontario
Job Status
Temporary, Full-Time (11:00 a.m. to 7:00 p.m.) Contract until December 31, 2015

Customer Service Opportunity in the Health/Dental Claims Contact Centre

As a: Dental/Health Adjudicator with Customer Service

 

This health/dental claims customer service role provides a great opportunity for someone who is looking for a career that involves providing excellent customer service to internal and external customers in a dental/medical-related field. The objective of the role is to effectively resolve health and dental phone calls/inquiries from customers (plan members, plan sponsors, advisors, GMMs, and external vendors).

Accountabilities:

  • Provide quality customer service to Policyholders, Group Offices, Head Office staff and Medical Providers, using a thorough knowledge of the claims area; the majority of the time involves handling incoming telephone calls.
  • Work with the Special Investigations Unit by identifying suspicious claims and alerting the department to the findings.
  • Consistently provide clear and concise communication with all claim decisions both verbally over the phone and in writing with each claim decision.
  • Contribute to the continuous improvement of business processes.
  • Develop and maintain a solid knowledge of: related legislation and Company practice; of policies currently and previously marketed by the Company.
  • Must be available to work "Western Shift" (11:00am to 7:00pm*) hours as required.
  • When required, accurately and timely process Health and Dental claims received within the appropriate guidelines and within published service standards.

*Western Shift hours are subject to change based on business requirements

 

Qualifications:

  • Bilingual in French and English is an asset, both spoken and written.
  • Dental and Medical terminology and related education.  Post secondary education preferred including dental assistant, pharmacy assistant, massage therapy, medical assistant, etc.
  • Superior interpersonal skills to manage relationships with internal and external clients.
  • Excellent listening skills to facilitate positive outcomes with inquires and irate callers
  • Ability to handle high stress levels in a fast paced production environment
  • Strong change management skills including Adaptability and Flexibility.
  • Ability to work effectively in a team environment
  • Excellent verbal and written communication skills
  • PC skills – working knowledge of MS office, MS Access, and keyboarding

How to Apply

To apply for this position, please email your cover letter, including salary expectations, and resume in one MSWord document to resumes@equitable.ca

If applying to multiple positions, please apply to each position separately.