Clerk 3 (OPOP/OPIP Claim Coordinator)

The Government of Nova Scotia•HALIFAX, NS

2d•CA$1,848 - CA$2,068•Onsite

About The Position

As a Health Claims Clerk, you will play an important role in supporting the administration of out-of-province healthcare claims for Nova Scotia residents. Working as part of the Benefits Eligibility team, you will review, process, and reconcile healthcare claims submitted by hospitals and health organizations across Canada. You will help ensure that claims are assessed accurately, payments are processed correctly, and inquiries are handled professionally and efficiently. This position is well suited to someone who enjoys detailed administrative work, problem solving, working with financial information, and providing excellent service to both internal and external clients.

Requirements

At least 4 years related experience performing administrative work that requires a high degree of accuracy and attention to detail in a computerized accounting environment; or an equivalent combination of training and experience may be acceptable.
Experience reviewing, processing, and maintaining records, financial transactions, or claims-related information.
Strong analytical and problem-solving skills with the ability to investigate discrepancies and resolve issues.
Experience working with computerized databases, financial systems, or record management systems.
Strong written and verbal communication skills.
Proven ability to manage multiple priorities while maintaining accuracy and confidentiality.
Processing health-related claims, benefits, insurance, or reimbursement transactions.
Working with financial reconciliation, accounts payable, or payment processing.

Nice To Haves

Working within the healthcare sector, public service, or a regulated environment.
Knowledge of reciprocal billing programs or health coverage administration.

Responsibilities

Review out-of-province outpatient hospital claims for accuracy and completeness.
Process claims and maintain records using specialized billing and tracking systems.
Verify eligibility for Nova Scotia health coverage and assess claim requirements.
Investigate discrepancies, adjustments, and billing issues.
Communicate with healthcare organizations, government partners, and residents regarding claim eligibility and reimbursement processes.
Prepare payment documentation and support financial reconciliation activities.
Record and maintain accurate claim and payment information for reporting and statistical purposes.
Process refunds, payment adjustments, and replacement payment requests.
Respond to inquiries from healthcare providers, government partners, and members of the public.
Assist with program reporting, special projects, and administrative support activities.
Contribute ideas and recommendations that improve processes, service delivery, and system effectiveness.
Provide backup support for mail pick up and distribution, and other team functions as required.