Competition Status: Position Filled
Approximately 148 individuals applied for this opportunity.
We have completed the recruitment process and successfully hired the top candidate into the position.
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Thank you for your interest in the Ontario Public Service.
Claims Assessor
Organization:
Ministry of Health and Long-Term Care
Division:
Direct Services Division/Claims Services Branch
Language of Position(s):
Bilingual English/French
Job Term:
1 Temporary (up to 12 months)
Job Code:
09OAD - Office Administration 09
Salary:
$24.15 - $28.15 Per Hour*
*Indicates the salary listed as per the OPSEU Collective Agreement.
Do you have in 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?
Mandatory
• You are proficient in English and in oral French at the advanced level.
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:
- 1 Bilingual English/French Temporary, duration up to 12 months, 5700 Yonge St, Toronto, Toronto Region, General Screening Requirement
Compensation Group:
Ontario Public Service Employees Union
Schedule:
3.7
Category:
Administrative and Support Services
Posted on:
Friday, March 23, 2018
Note:
- This ad is also available in French.
- In accordance with the Ontario Public Service Employment Screening Checks Policy, the top candidate(s) may be required to undergo a security screening check. Please refer to the Additional Information / Address section above to determine the screening checks that are required for this position.
You will be responsible for obtaining the criminal record check at your own expense and provide it, along with your written consent, to the Transition and Security Office (TSO), HR Service Delivery Division to evaluate the results. If applicable, the TSO, with your written consent, will request and obtain any additional screening checks as indicated in the Additional Information / Address section above that were not obtained directly by you. (Note: If a Vulnerable Sector Screening/Check is required, it must also be obtained in person at your local police service.)
A record under the Criminal Code and/or other federal offence record(s) does not automatically mean you will be ineligible for the position. The screening check(s) will only be reviewed and evaluated by the TSO for the purpose of making a security clearance decision. The details of an individual's screening check(s) will be considered in specific relation to the duties and responsibilities of the position being filled. Screening check records will be maintained by the TSO and kept strictly confidential. - T-HL-121520/18
Please be advised that the results of this competition may be used to form an eligibility list of qualified candidates to potentially fill future vacancies represented by the Ontario Public Service Employees Union (OPSEU). In accordance with the Collective Agreement, eligibility lists are shared with OPSEU representatives. By applying to this competition, you are providing consent that your name may be shared with OPSEU representatives.
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 as applicable 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 being offered a position with the Ontario Public Service for a specific time period (e.g. one year), or from being offered 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 Tuesday, April 10, 2018 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.
All Ontario Public Service external job advertisements are posted in English and French. To confirm the language requirements of a job, check the "language of position" information at the top of each job ad. For all positions, candidates will be assessed in English, the business language of the Ontario Public Service. For English/French designated bilingual positions, candidates will also be assessed through French-language proficiency testing.
Toutes les offres d'emploi externes de la fonction publique de l'Ontario sont affichées en anglais et en français. Pour connaître les exigences linguistiques, vérifiez les renseignements sur la « langue du poste » figurant dans le haut de chaque offre d'emploi. Pour tous les postes, l'évaluation des candidates et candidats se fera en anglais, la langue usuelle de la fonction publique de l'Ontario. En ce qui concerne les postes désignés bilingues, la maîtrise du français des candidates et candidats sera également évaluée.
