Claims Processing Specialist

As a Claims Processing Specialist, you’ll be responsible processing performance-based funding alongside employment- related financial supports for clients and employer expenditures. You will work closely with the Claims Manager and Financial Quality and Support Specialist to ensure accuracy, compliance and continuous quality improvement while maintaining high level of confidentiality pertaining to client records and financial information. You will process client and employer financial support claims and ensure contractual and legislative requirements are met. Ensure quality assurance for claims/invoices processed by Service Provider staff. Answer inquiries from staff regarding claims and other administrative questions. Communicate any issues regarding ineligible claims in line with processes. Provide support and guidance to staff regarding claims processing in line with contractual and guideline requirements. Keep abreast of emerging trends for claims assessment and flag these to the Claims Manager. You will also demonstrate flexibility to be able to change activities based on changing requirements and business needs and ensure discrepancies are handled appropriately and escalating issues when necessary; refer staff to appropriate team members or internal partners as appropriate. Protect the interests of the organization – identify and manage risks, and escalate non-standard, high-risk transactions / activities as necessary. Develop a strong understanding of WCG’s contract, guidelines, policies, and process and undertake standard and ad hoc data entry tasks and use WCG’s Case Management System and other systems and databases effectively.