Claims administrator

Medisys Health Group, Inc. - Greater Sudbury, ON (30+ days ago)

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Claims Administrator

(Short Term Disability Administrator)

Location: 144 Pine St., Suite 401, Sudbury, Ontario
Status: Permanent full-time
Schedule: Days - Monday to Friday

Job description
The Claims Administrator is responsible for assisting employees on behalf of the employer, when the employee is going off work for non-occupational health reasons. The Claims Administrator will provide information and guidance to all employees regarding their short-term disability insurance. The incumbent of this position will also provide administrative, record keeping as well as file control.

Role and responsibilities

Initial and follow up communication with the employee, explanation of the Short Term Disability process, forward medical information to the insurance company and the Case Manager for the employee’s claim
Act as liaison with the insurance company adjudicator
Maintain an ongoing knowledge of the adjudication of the claim for communication with the Case Manager, Management and the employee
Receive claims adjudication notifications, updates and requests from the insurance company, process and distribute as required
Maintain written, computer based and historical records of all STD claims
Provide the employer with information regarding STD claims for benefit related issues.
Responsible for creating, reviewing, and updating various reports and databases Provide Metrics information for monthly, quarterly and annual reporting to Vale
Receive, organize and distribute Treatment Provider Physio Reports to the Case Managers
Answer incoming phone inquiries for the Disability Management Department and direct to appropriate personnel
Coding of invoices for payment, manage chargeback and reimbursement information on an Excel database
Other projects and tasks as assigned


High School diploma and Community college diploma in medical secretarial/office administrator and/or equivalent years of experience
Minimum of 3 years of experience in a similar role
Proficiency with Microsoft Office applications (Word, Outlook, Excel and PowerPoint)
Personal qualities must include a high level of maturity, professionalism, respect for confidentiality and commitment to a superior level of customer satisfaction;
Demonstrates effective organizational, multitasking and problem solving abilities
Experience in the delivery of health or business-related services and/or knowledge of case management and/or group benefits, an asset

Company Description

Horizon OHS is the occupational health division of the Medisys Health Group. We are Canada’s leading nationwide provider of corporate health services and we have been delivering integrated health management programs to organizations for almost 30 years.

Our team of highly skilled professionals provide clinical and remote medical services across Canada at our 26 locations. We provide a full range of health services such as on-site nurses and paramedics, on-call physicians, surveillance programs, pre-employment health screenings, first responder emergency services, primary care, MEDEVAC/incidence response, and wellness services. Horizon focuses on providing all aspects of worker health management, from our pre-employment testing and medical screenings, to our on-site care and treatment. We also provide emergency response and return to work management.

We wish to thank all applicants in advance for their interest; however, only those who will be considered for an interview will be contacted. Committed to employment equity, Medisys encourages applications from the four designated groups as identified in the Employment Equity Act. Accommodation will be provided in all parts of the hiring process as required under the Medisys Accommodation Policy. Applicants are required to make their needs known in advance. Please note that we are recruiting only people who are entitled to work legally in Canada.