The overall responsibility in this position is to ensure that the claims we receive are appropriately managed. This involves accurate and efficient entry and adjudication of claims.
Responsibilities
Enter and manage claims to ensure timely payment for our providers and members.
Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance is required.
Respond to inquiries from internal customers regarding all aspects of benefits and claims assessment.
Follow through to ensure effective and efficient resolution of all inquiries.
Contact providers and members to obtain the necessary information to assess claims.
Adjudicate claims in accordance with unit procedures and Claim Services standards with a high degree of accuracy and efficiency.
Monitor individual production to ensure that claim turnaround and volume expectations are met.
Make suggestions to improve workflows and processes.
WHAT YOU WILL HAVE:
Demonstrated excellence in verbal communication and listening skills in the delivery of superior service to customers in previous roles.
Demonstrated excellence in accuracy and multi-tasking under tight time frames and heavy workload.
Demonstrated ability to work with minimal supervision and within a team environment.
Demonstrated problem-solving and decision-making capabilities as well as strong organizational skills.
Strong attention to detail and a desire for continuous learning.
Proficiency with Microsoft Office Suite is required.
Willingness to work scheduled shifts within business hours of 8:00 a.m. and 5:00 p.m.
Willingness to work extra hours and overtime hours as needed.
This position will remain open until suitable candidates are selected.
Alberta Blue Cross® is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.
We offer the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, apply online at careers.ab.bluecross.ca
A criminal record check satisfactory to Alberta Blue Cross will be required as a condition of employment, following a conditional offer.
Benefits
Health insuranceVision insurance
Additional Information
Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. We're committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. We believe in what we do-and place trust in our employees to deliver our vision.
Working at Alberta Blue Cross® means having a career where you'll be recognized for your contributions. We value diversity, encourage our team members to maintain a healthy work-life balance and provide opportunities for career growth.
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