Claims Coordinator (12-Month Contract)

Disability Management Institute•,

4d•Remote

About The Position

The Claims Coordinator (12-Month Contract) is the first point of contact for employees who have Disability and Life and Living coverage adjudicated by DMI or an external carrier. The Claims Coordinator is responsible for explaining the claims application processes, and reviewing and processing all claims-related paperwork. This is a contract and remote role within Canada. We are open to candidates across the country, however you must work within our core business hours.

Requirements

2 years of previous administrative and/or customer service experience.
Competence in Microsoft Excel, Outlook, and Word.

Nice To Haves

Previous benefits experience is an asset.

Responsibilities

Review all new referrals from employers with Disability coverage adjudicated by DMI or stand-alone WOP benefits.
Set up clients with Early Intervention services and MTD/LTD coverage as Pre-claim files and refer to the EIP team for app facilitation, RTW planning, and app submission to carrier.
Forward completed claims to the Intake Coordinator for claim set-up and assignment to a Case Manager.
Set up internally adjudicated Life and Living claims and facilitate the claim through to assignment to a Case Manager.
Receive and review all new claim documents and referrals for Disability and Life & Living applications for various insurance carriers in accordance with their defined processes.
Set up new files, verifying all administrative details required when submitting a claim for benefits, including absence dates and personal contact information.
Assemble and submit claims to external carriers following standard procedures, maintaining claim records and communicating updates to relevant stakeholders until closure.
Discuss the application process with employees and employers and ensure all correct paperwork is in order.
Verify all administrative details required when submitting a claim for benefits, including absence dates, personal contact information, enrollment cards, and contracts.
Review all application paperwork received to ensure it is complete and accurate; follow up with the relevant party to resolve any errors or omissions.
Follow up on outstanding paperwork and ensure all stakeholders are kept updated.
Review policy information to confirm insurance coverage for clients; escalate questions to the appropriate party where identified.
Identify cases where return to work may be feasible prior to claim submission and propose and monitor plans.
Notify the GS and GH billing administration team to apply applicable updates to WEBS.
Respond to all inquiries, emails, and voicemails within 1 business day of receipt.
Ensure all relevant file information is completely and accurately entered into the appropriate fields in the proprietary database management system.
Manage incoming and outgoing phone calls in alignment with role responsibilities.
Submit IT tickets for enhancements and support in conjunction with leadership sign-off.
Provide input where inefficiencies are identified to improve outcomes and increase efficiency.
Perform all other duties as required.