Ontario Public Service Careers - Job Preview
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Competition Status: Posting Closed

Approximately 527 individuals applied for this opportunity.

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Thank you for your interest in the Ontario Public Service.

CLAIMS ASSESSOR (TALENT POOL)
Organization:    Ministry of Health and Long-Term Care
Division:    Direct Services Division/Claims Services Branch
City:    Oshawa
Job Term:    Permanent, Temporary
Job Code:    09OAD - Office Administration 09
Salary:    $23.46 - $27.35 Per Hour*
Posting Status:    Open
Job ID:    56848
 View Job DescriptionView Job Description
 

Do you have an interest in providing timely, accurate and cost effective delivery of claim services to health care providers and the public in support of the Ministry of Health and Long-Term Care's health care delivery strategies? If so, bring your knowledge of medical terminology, human anatomy and your ability to authenticate, adjudicate and facilitate payment of claims for health care benefits to our team!

What can I expect to do in this role?

You will:

•Use your research skills to assess claims and analyze payment irregularities within strict deadlines.
•Respond to inquiries.
•Initiate payments, adjustments or recoveries.
•Provide service to medical providers and the public.
•Deal with confidential and sensitive medical and personal information.

How do I qualify?

KNOWLEDGE:
• Demonstrated knowledge of medical terminology and human anatomy to read and understand operative and emergency reports.
• Proven ability to understand, interpret and apply policies, work within guidelines, procedures and legislation to process claims and protect information and determine its disclosure.

RESEARCH AND ANALYTICAL SKILLS:
• Ability to evaluate and adjudicate stakeholder claims.
• Ability to determine appropriate payment.
• Proven ability to apply discretion and judgement to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.

ORGANIZATIONAL SKILLS:
• Ability to organize and manage own workload, process a high volume of claims and inquiries within strict timeframes.

TACT, DIPLOMACY AND COMMUNICATION SKILLS:
• Demonstrated ability to provide detailed and understandable explanations (oral and written) on work processes and claims payments to internal and external clients.
• Demonstrated interpersonal skills to interact with clients and team members and to understand and respond appropriately to issues, dealing with conflict situations and/or with sensitive medical/financial information.
•Demonstrated experience working cooperatively in a team to meet deadlines and organization goals and assisting in the training of new and existing employees.

MATHEMATICAL AND COMPUTER SKILLS:
• Ability to calculate fees, recognize billing irregularities and reconcile payments and adjustments.
• Working knowledge of personal computers, mainframe applications, software (e-mail, word processing, internet, databases) and keyboarding skills to input/access/retrieve information and create correspondence and reports.

Additional information:

Address:  
  • Permanent, 419 King St W, Oshawa, Central Region
  • Temporary, duration up to 0 months, 419 King St W, Oshawa, Central Region
Compensation Group:   Ontario Public Service Employees Union
Schedule:   3.7
Category:   Administrative and Support Services
Posted on:   Thursday, September 12, 2013
 
Note:
  • Prior to the offer of employment, in accordance with the Ontario Public Service personnel screening checks policy, the top applicant(s) will be required to undergo personnel screening checks, which includes a police records check.
  • The number of positions to be filled has not been identified at this time. This competition will be used to create an eligibility list of qualified candidates to fill upcoming opportunities within the next eighteen months following the closing date of the job ad posting.
All external applicants (including former employees of the Ontario Public Service) applying to a competition in a ministry or Commission public body must disclose (either in the cover letter or resume) previous employment with the Ontario Public Service. Disclosure must include positions held, dates of employment and any active restrictions from being rehired by the Ontario Public Service. Active restrictions can include time and/or ministry-specific restrictions currently in force, and may preclude a former employee from applying and/or accepting a position with the Ontario Public Service for a specific time period (e.g. one year), or from applying and/or accepting a position with a specific ministry (either for a pre-determined time period or indefinitely). The circumstances around an employee's exit will be considered prior to an offer of employment.
 
Remember: The deadline to apply is Thursday, September 26, 2013 11:59 pm EDT. Late applications will not be accepted.

We thank you for your interest. Only those selected for further screening or an interview will be contacted.



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The Ontario Public Service is an inclusive employer.
Accommodation is available under the Ontario Human Rights Code.

Note: The only website where you can apply on-line for positions with the Ontario Public Service is http://www.gojobs.gov.on.ca

 
*Indicates the salary listed as per the OPSEU Collective Agreement.
 
 
 
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