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.
