Hi, Can I apply under NOC: 1122, I am working as Medical Claims Adjuster in Insurance company job responsibility are :
- Handling 7 people (new joiner) as a mentor.
- Review Medical Health Insurance claims i.e. (Vision, Paramedical, Lab, Equipment, Out of Country and Drug Claims) of policy holder to ensure they are complete and accurate.
- Knowledge of Vision Claims (New Frame with Glasses, Eye Exam etc.)
- Knowledge of Paramedical Claims (Massage Therapy, Physiotherapy etc.)
- Knowledge of Drug Claims (Drug from Pharmacy or Medical Doctor etc.)
- Knowledge of Lab Claims (Blood Test, Ultrasound, Scan etc.)
- Understand Co-ordination of Benefit with other existing policy or other company policy.
- Use proper guidelines and decision making to approve or denied the claims.
- Co-ordinate with Assistant Manager regarding any special policy.
- Before release the claim validates all the required information.
- Process claim under the Health Spending Account on policy holder request.
- Understand provincial involvement in Drug Claims.
- Working knowledge on these application Chess, Ultera, Himster, Spector etc.
- Worked on Alt Payee Project and handled all MIS work successfully.