Member Services Claims Adjudicator (St. James Industrial)

Member Services Claims Adjudicator (St. James Industrial)

28 Oct
|
Manitoba Blue Cross
|
St. James Industrial

28 Oct

Manitoba Blue Cross

St. James Industrial

Apply claims adjudication and analytical skills with Manitoba Blue Cross in Winnipeg and surrounding areas. Help members understand coverage and resolve claim issues.

As a Member Services Representative, you will process Ambulance/Hospital, Extended Health, Dental, and spending account claims. You will also address inquiries, pre-authorizations, Coordination of Perks, and missing information. Accuracy, judgment, organization, and professional communication are central to this work.

Key Responsibilities:

- Process claims and pre-authorizations according to performance standards
- Manage pended claims and service-level agreement requirements
- Review processed claims and complete corrective actions
- Return incomplete claims and obtain required additional information




- Complete inquiry tickets, forms, memos, and document management tasks

Requirements:

- Business Administration education or equivalent relevant experience
- Strong problem-solving, analytical, and numerical skills
- Accurate data entry and documentation abilities
- Organizational skills for multiple priorities and deadlines
- Health benefits or healthcare experience considered an asset

Use careful analysis, claims expertise, and member communication to deliver accurate service through Manitoba Blue Cross.

📌 Member Services Claims Adjudicator (St. James Industrial)
🏢 Manitoba Blue Cross
📍 St. James Industrial

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