Claims Review Specialist - 12-month Contract

Overview

Temporary Full Time. We are looking for a Claims Review Specialist. Reporting to the Supervisor, Claims Review, the Claims Review Specialist is a key member of the Audit and Claim Verification team responsible for completing claim audit processes for a key Canada Life client. The main function of the Claims Review Specialist is to conduct standard claims reviews of providers and members. The Claims Review Specialist will also handle escalations and non-responses from other units within Canada Life.

Responsibilities

• Conduct claims reviews, including assessment of documentation for preselected claims
• Handle referrals from other business units, to investigate concerns identified and follow up on non-responses
• Prepare communications to be sent to members and providers seeking confirmation or clarification of claim information
• Receive, file and action claim review documentation from providers and members
• Identi...