• Provided assessment, analysis and management of complex STD, LTD, and life waiver claims from inception to conclusion for variety of group clients.• Rendered a variety of claims decisions and approved the release of payments based on contractual and company guidelines. • Proficient in handling both cold and warm inbound & outbound calls, which helped reduce call volumes. • Provided Mentoring to junior employees on a variety of… Show more • Provided assessment, analysis and management of complex STD, LTD, and life waiver claims from inception to conclusion for variety of group clients.• Rendered a variety of claims decisions and approved the release of payments based on contractual and company guidelines. • Proficient in handling both cold and warm inbound & outbound calls, which helped reduce call volumes. • Provided Mentoring to junior employees on a variety of topics,which lead to reduction of claims handling time. • Initiated, developed and managed employee return to work plans including the facilitation of return to work meetings between employees, employers & vocation rehabilitation consultants, leading to the successful return to employment of 80% of claimants, leading to employer cost reductions. • Set and managed case reserves, thus allowing company to reinvest savings into new products Show less

Concurrently managed a mixture of 7- 10 large and small pharmaceutical projects. • Fulfilled team leader role for large, 2000 live, cardiovascular medication compliance study, which lead to the client ordering additional business. • Obtained drug cost approval for claimants requiring expensive medications, which lead to an increase in the number of claimants obtaining required oncology treatment. • Completing adverse event… Show more Concurrently managed a mixture of 7- 10 large and small pharmaceutical projects. • Fulfilled team leader role for large, 2000 live, cardiovascular medication compliance study, which lead to the client ordering additional business. • Obtained drug cost approval for claimants requiring expensive medications, which lead to an increase in the number of claimants obtaining required oncology treatment. • Completing adverse event reporting to Health Canada for a variety of pharmaceutical clients. • Researched, coordinated and screened registration forms for Phase 4 pharmaceutical projects which ensured data quality compliance for the project. • Provided inbound and outbound customer service in call center setting for multiple time sensitive projects. Show less

Adjudicated a variety of extended health, prescription, dental, travel and hospital claims per contract, company policies and provincial guidelines, allowing department to meet claim handling requirements.Liaised with clients, claimants, medical and legal representatives as well as third party vendors for missing information, which lead to increase in claim approvals Researches and developed standard operating procedures for department online resource, leading to improved coworker… Show more Adjudicated a variety of extended health, prescription, dental, travel and hospital claims per contract, company policies and provincial guidelines, allowing department to meet claim handling requirements.Liaised with clients, claimants, medical and legal representatives as well as third party vendors for missing information, which lead to increase in claim approvals Researches and developed standard operating procedures for department online resource, leading to improved coworker knowledge base.Concurrently provided Mentoring to 3-4  junior claims examiners, which lead to improved claim turn around times. Show less

Prepared and submitted online OHIP billings for six physicians daily & investigated & corrected any payment irregularities received back from OHIP. Prepared invoices for block fee patient payments.(non OHIP) & obtained subsequent payments from patients. Followed up with various  insurance companies regarding outstanding doctor fees requested for form completion, leading to improved clinic financial situation.Created patient charts, contacted patients to book appointments to discuss… Show more Prepared and submitted online OHIP billings for six physicians daily & investigated & corrected any payment irregularities received back from OHIP. Prepared invoices for block fee patient payments.(non OHIP) & obtained subsequent payments from patients. Followed up with various  insurance companies regarding outstanding doctor fees requested for form completion, leading to improved clinic financial situation.Created patient charts, contacted patients to book appointments to discuss test results. & ensured medical documentation was entered into patient files prior to patient visits, allowing for more efficient patient treatment.Backed up reception desk as needed to ensure re-booking of appointments for six general physicians. Show less