Claims Assessor (1 Bilingual, English-French and 1 Unilingual)

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Apply By: Thursday, November 26, 2026 11:59 pm EST

Claims Assessor (1 Bilingual, English-French and 1 Unilingual)

Job ID:

251251

Posting status:

Open

Organization:

Ministry of Health

Division:

Ontario Health Insurance Plan Division/Claims Services Branch

City:

Ottawa

Position(s) language:

Both English and bilingual

Job term:

1 Permanent, 1 Temporary assignment/contract for 12 months with possibility of extension

Job code:

09OAD - Office Administration 09

Salary:

$28.14 - $32.82 Per hour*
*Indicates the salary listed as per the OPSEU Collective Agreement.

Apply now

Accessibility support

Join Our Team as a Claims Assessor!
Are you passionate about making a difference in the healthcare sector? Do you thrive on providing timely, accurate, and cost-effective services? If so, we have the perfect opportunity for you!

As a Claims Assessor, you'll play a crucial role in supporting the Ministry of Health's healthcare delivery strategies. You'll utilize analytical and research skills and medical knowledge to authenticate, adjudicate, and facilitate the payment of claims for Ontario healthcare benefits. Our office is located in the heart of the city's vibrant Little Italy district, surrounded by some of the best Italian restaurants and cafés—perfect for a delicious lunch break or after-work bite.

What We Offer:
• A dynamic and supportive work environment
• Opportunities for professional growth and development
• The chance to make a real impact on the lives of Ontario healthcare providers and the public

Bring your skills and passion to our team and help us deliver exceptional claim services. Apply now and be part of a mission that truly matters!

About the job

You will:

• Use your research skills to assess claims and analyze payment irregularities within strict deadlines.
• Respond to complex inquiries such as billing irregularities, payment discrepancies, etc.
• Initiate payments, adjustments or recoveries.
• Provide service to medical providers and the public.
• Deal with confidential and sensitive medical and personal information.

What you bring to the team

Mandatory Requirement (For the Bilingual Position Only):

• You must possess oral French language skills at the advanced level. Your proficiency level will be confirmed before hire.

Knowledge:

• Demonstrated knowledge of medical terminology and human anatomy to read and understand operative and emergency reports.
• Proven ability to understand, interpret and apply policies, work within guidelines, procedures and legislation to process claims and protect information and determine its disclosure.

Research and Analytical Skills:

• Ability to evaluate and adjudicate stakeholder claims.
• Ability to determine appropriate payment.
• Proven ability to apply discretion and judgement to confirm eligibility for programs, determine when to escalate contentious issues/claims and adjudicate payment as applicable.

Organizational Skills:

• Ability to organize and manage own workload, process a high volume of claims and inquiries within strict timeframes.

Tact, Diplomacy and Communication Skills:

• Demonstrated ability to provide detailed and understandable explanations (oral and written) on work processes and claims payments to internal and external clients.
• Demonstrated interpersonal skills to interact with clients and team members and to understand and respond appropriately to issues, dealing with conflict situations and/or with sensitive medical/financial information.
•Demonstrated experience working cooperatively in a team to meet deadlines and organization goals and assisting in the training of new and existing employees.

Mathematical and Computer Skills:

• Ability to calculate fees, recognize billing irregularities and reconcile payments and adjustments.
• Working knowledge of personal computers, mainframe applications, software (e-mail, word processing, internet, databases) and keyboarding skills to input/access/retrieve information and create correspondence and reports.

Don't meet every qualification?

If you are excited about this position and meet most, but not all, of the listed qualifications, please still consider applying. We recognize that no one person might have every qualification in this job ad, and you just might be the right candidate!

How we support diversity, inclusion and accessibility

We are building an inclusive workforce that reflects the communities we serve. We encourage everyone interested in working with us to apply, including people with disabilities, Indigenous, Black and racialized individuals, as well as people from all ethnicities, cultures, sexual orientations, gender identities and gender expressions.

Our hiring process is accessible, consistent with Ontario's Human Rights Code and the Accessibility for Ontarians with Disabilities Act, 2005. We are working to prevent and remove barriers in our hiring processes and can offer accommodation to address specific needs related to Code-protected grounds such as disability, family status and religion. For more information about accommodation during the hiring process please contact us.

Learn more about the work the OPS is doing to create an inclusive, anti-racist, accessible and diverse workplace:

• diversity, equity and inclusion initiatives
• accessibility
• Anti-Racism Policy

What we offer

The Ontario Public Service is one of Ontario's largest employers. Employees work for a wide range of ministries, with offices in more than 70 cities across the province. We offer:

• a career that can grow across ministries and job functions
• flexible learning and developmental opportunities, including education and mentorship programs
• many employee networks offering support for and education about underrepresented groups
• tailored work arrangements, including opportunities like flex hours, self-funded leave and more

Our comprehensive compensation and benefits package includes:
• a defined-benefit lifetime pension plan (guaranteed, ongoing inflation-protected income after retirement)
• group health, dental, life and disability benefits
• a range of vacation and leave options
• an Employee and Family Assistance Program, which provides confidential counseling services

Additional information:

Apply by:

Thursday, November 26, 2026 11:59 pm EST

Position details:

• 1 Bilingual English/French Permanent, 347 Preston St, Ottawa, East Region, Criminal Record Check
• 1 English Temporary, duration up to 12 months, 347 Preston St, Ottawa, East Region, Criminal Record Check

Compensation group:

Ontario Public Service Employees Union

Work hours:

Schedule 3.7

Category:

Administrative and Support Services

Posted on:

Wednesday, November 11, 2026

Note:

• This ad is also available in French.
• About security checks:
  A criminal or other federal offence record does not automatically disqualify you from the position. We consider each situation based on the position's responsibilities.
  If a check is needed and you've lived outside of Canada in the past 5 years for 6 or more months in a row, or if you are not a Canadian resident, you'll need to provide an out-of-country police clearance certificate from the country you lived in.
  Employment screening checks are only reviewed and evaluated by the Transition and Security Office, which also maintains them and keeps them strictly confidential.
• N-HL-251251/26(2)

How to apply:

1. You must apply online.
2. Your cover letter and resume combined should not exceed five (5) pages. For tips and tools on how to write a concise cover letter and resume, review the Writing a Cover Letter and Resume: Tips, Tools and Resources.
3. Customize your cover letter and resume to the qualifications listed on the job ad. Using concrete examples, you must show how you demonstrated the requirements for this job. We rely on the information you provide to us.
4. Read the job description to make sure you understand this job.
5. OPS employees are required to quote their WIN EMPLOYEE ID number when applying.
6. If you require a disability related accommodation in order to participate in the recruitment process, please Contact Us to provide your contact information. Recruitment services team will contact you within 48 hours.

Language requirements and assessment:
All external Ontario Public Service (OPS) job ads are posted in English and French. Check the "position(s) language" section at the top of each job ad for the language requirements. For all roles, candidates are assessed in English, the business language of the OPS. If the position is bilingual (English/French), you'll also need to pass a French-language proficiency test.

Exigences en matière de langue et évaluation:
Toutes les offres d'emploi externes de la fonction publique de l'Ontario (FPO) sont affichées en français et en anglais. Consultez la section « Langue du ou des postes » en haut de chaque offre d'emploi pour connaître les exigences linguistiques. Pour tous les postes, les candidats sont évalués en anglais, la langue d'affaires de la FPO. Si le poste est bilingue (anglais/français), vous devrez également passer un test de compétences linguistiques en français.

Strengthening Ontario, together