Current Open Opportunities
Want to take your career to the next level?
We’re looking for top talent, with a passion for supporting the well-being of others and providing exceptional service, to join our dedicated and conscientious team.
Responsible for providing efficient, consistent and professional bilingual customer service to plan members and providers both via prompt phone or email correspondence. Reporting to the CRC Manager, call centre agents must also ensure that all policies and procedures are followed in order to meet ClaimSecure’s accuracy rate and standard turnaround times. The CRC agent is also responsible for file maintenance, investigating claim payments and forwarding claims for re-evaluation.
Standard:
- Calls received in the queue must be answered promptly and within the established service level thresholds
- Calls left on voice mails must be returned the same business day. If the message is left after 3pm EST, then it must be dealt with the next morning.
- Calls that require research must be followed up within 1 business day and resolved within 3 business days.
- Calls will be monitored to ensure quality of service
- Company standards must be followed and adhered to in respect to follow up and response times. The above mentioned standards may change and all stakeholders will be notified.
File Maintenance:
The CRC agent is responsible for departmental file maintenance. This includes but is not limited to the following:
- Formulary maintenance
- Exception file
- Special Authorization Groups
- Calls will be monitored to ensure quality of service
- Research difficult claims The CRC agent must participate in regular training sessions of all new products. The agent must have thorough knowledge of these applications to help answer questions from members and clients.
Training:
The CRC agent must participate in regular training sessions of all new products. The agent must have thorough knowledge of these applications to help answer questions from members and clients.
Skills:
- Grade 12 with up to one year or equivalent program, with preferred requirement of other vocational or professional certification
- One to two years’ experience in a related field (ie. Data Entry, Call Centre)
- Experience in the Health Related field would be an asset
- Excellent listening and communication skills (both written and oral) which will assist in providing quality service
- Sound knowledge of MS Office
- Good interpersonal skills and the ability to function in a team environment
- Good organizational skills and the ability to prioritize workload will assist to maintain company standards
- Ability to handle multiple tasks and meet pre-determined deadlines
Supporting the Claims Admin Team throughout the adjudication process, the Claims Administrator is responsible for processing all submitted paper, eClaims, PhotoClaims and pre-determinations, or estimates, for plan members and providers within established turnaround times and accuracy rates.
The Software Developer’s role is to design, code, test, and analyze software programs and applications. This includes researching, designing, documenting, and modifying software specifications throughout the production lifecycle. The Software Developer will also identify and rectify software errors in a timely and accurate fashion and provide status reports where required.
Principal Responsibilities:
- Assist other developers, analysts, and designers in conceptualizing and developing new software programs and applications.
- Assist in the research, preparation and documentation of software requirements and specifications.
- Conduct research on emerging application development software products, languages, and standards in support of development efforts.
- Recommend, schedule and perform software improvements and upgrades.
- Consistently write, translate and code software programs and applications according to specifications.
- Run and monitor software performance tests on new and existing programs for the purposes of correcting errors, isolating areas for improvement, removing security holes and general debugging.
- Assist in the development and maintenance of user manuals and guidelines.
- Write detailed test plans and software implementation documents.
- Write programming scripts to enhance functionality and/or appearance of company Web site and/or related Web applications as necessary.
- Liaise with administrators, database analysts and business experts to resolve problems with software.
Knowledge, skills and experience:
- College diploma or university degree in the field of computer science or software engineering and 1-4 years’ equivalent work experience
- Working technical knowledge of programming languages and protocols, such as [ASP.NET, C#, VB.NET, ADO.NET Entity Framework, LINQ, CSS, JavaScript, HTML5, Microsoft SSIS, SSRS, SAML, Web APIs]
- Experience with SQL Server and Oracle databases and programming including T-SQL and PL/SQL
- Hands on experience working in IDE’s, including Microsoft Visual Studio 2013 and Team Foundation Server. Experience with Xcode and Android Studio IDE’s an asset
- Hands-on software troubleshooting experience
- Knowledge of applicable data privacy practices and laws
- Experience with software development life cycles
- Familiarity with Agile software development principles (Waterfall and Hybrid experience are an asset)
- Familiarity with the health claims management industry is considered an asset