Vision Claims Consultant (Part-time, 4 hours/week)
AMD Inc.
Kitchener, ON

JOB TITLE: Vision Claims Consultant (Part-time, 4 hours/week)
DURATION: 6 months (potential for extension)
LOCATION: Kitchener, ON

RESPONSIBILITIES:

  • Ability to challenge their peer when identifying questionable actions and claims.
  • A reputable member in the industry and involved with up keeping the highest industry standards and guidelines.
  • Operates and services in accordance to their College standards guidelines.
  • Review claims from MLI viewpoint for fraud, abuse, inappropriate billings and embellishing on notes.
  • Willing/able to assist MLI in identifying and handling fraud/abuse.
  • Assist in the preparation for college complaints, criminal referrals and restitution conversations.
  • Willing to provide R&C (reasonable and customary) charges VS what is the norm (inflated charges).
  • Ability to direct analyst/investigator and provide input on next steps.
  • Ability to review cases independently and without direction from analyst/investigators.
  • Strong leadership skills with proven track record in mentoring and coaching staff.
  • Ability to juggle multiple priorities and perform under pressure while maintaining professionalism.
  • Strong documentation and case management skills.
  • Manage and collaborate with public and private special investigation units.
  • Ability to do background recherche when required to assist in an investigation.
  • Willingness to challenge MLI’s decision(s) to ensure Manulife is in the best position possible by effectively mitigating risk.
  • Liaise with legal, compliance, claims, customer service, advisors, consultants, underwriting, group field offices and professional associations and agencies as required in the course of an investigation

MUST HAVE

  • Degree in Optometry from an accredited institution
  • 5+ years experience in Optometry
  • Ability to do background recherche when required to assist in an investigation.

NICE TO HAVE

  • Strong leadership skills with proven track record in mentoring and coaching staff.
  • Strong documentation and case management skills.

Job Types: Part-time, Contract

Experience:

  • Optometry: 2 years (Required)

Education:

  • Bachelor's Degree (Required)