Products / Services
Competition Number:
2014-006
Competition Dates - From: 
Thursday, January 09, 2014
To: 
Friday, January 31, 2014
Title:
Claims Analyst
Location:
Moncton
Employment Type:
Full-Time, Permanent
Salary:
$27,516 - $34,395
Description:

“To help improve the health and well-being of people and their communities.”

Recognized as one of Canada’s 10 Most Admired Corporate Cultures, Medavie Blue Cross understands each one of its 1,900 employees plays a key role in building a strong and successful organization. Throughout the six provinces in which we operate, we know our people make a difference in our customers’ lives each day.  We encourage our employees to be involved and to support activities that allow for personal and professional growth and development. As a not-for-profit organization, we also place a high priority on giving back to the communities in which we live.

If you are looking for an opportunity in a challenging, fast-paced and team-oriented work environment with a leading local organization, the career you’ve been looking for may be waiting for you at Medavie Blue Cross.


Role Summary:
Medavie Blue Cross’ success in the delivery of services, solutions and products is evidenced by the strong government relationships that have existed throughout our 60-year history.  Many successful public-private partnerships have been forged with various federal and provincial governments in the delivery of health care services.  Working in a team environment, you communicate with key customers by telephone and/or in writing in a knowledgeable and personable manner.
As a Claims Analyst, you work with a wide variety of prescription drug claims with varying degree of eligibility and policy requirements.  The incumbent assesses, analyzes, investigates and pays prescription drug claims.  The Claims Analyst is required to remain current with respect to policy and procedure changes and will liaise closely with the Pharmacy Consultant, co-workers and Management.
Hours of work are 36.25 hours/week and individuals must be available to work on a rotational basis between core business hours of 8 a.m. – 5 p.m., Monday to Friday.
As a Claims Analyst, your key responsibilities will include:
  • Review, analyze, investigate and authorize payment of claims within guidelines;
  • Correspond with beneficiaries and providers; 
  • Produce various reports for finance and customer;
  • Maintain tracking records;
  • Organize work and information to ensure claims are paid accurately and efficiently;
  • Use business knowledge and experience to solve routine problems;
  • Decipher detailed reports in order to provide appropriate payments of service;
  • Liaise with service providers, their staff and vendors in a professional manner with respect to system use, claims submissions and payment reconciliations;
  • Adhere to privacy guidelines following proper procedures;
  • Produce clear and effective written materials;
  • Provide advice and recommendations to People Leader regarding procedures development relating to policy changes requested by the Department of Health;
  • Support and follow policies defined by the Department of Health;
  • Adhere to the performance measures under the Service Level Agreement Contract;
  • Review and provide input for the maintenance and upkeep of the procedural documentation;
  • Provide operational support to the Provincial Programs.
As the ideal candidate, you possess the following qualifications:

Education: High school and one year post-secondary diploma or equivalent.

Work Experience: 1 to 2 years relevant experience.

Other Qualifications:

  • Highly effective listening skills to ascertain customers’ needs, and determine appropriate action required for resolution. Excellent verbal skills for explaining complex issues to customers. Excellent written communication skills
  • Possess excellent communication skills, both oral and written;
  • Ability to work on a variety of tasks
  • High attention to detail;
  • Have a positive attitude and the desire to be a team player
  • Work well with limited supervision;
  • Work  well in a fast-paced office environment;
  • Possess good customer service skills;
  • Strong organizational skills and a high level of accuracy    
Computer Skills: Experience working in a PC setting with multiple software applications including experience navigating between applications and the internet. Strong keyboarding skills and the ability to enter data with speed and precision. Also, have accurate typing skills and a strong knowledge of PC software programs (particularly Microsoft office, Word and Excel);

Language Skills: Proficient in French and English both spoken and written is required for this position

If you are interested in working with a team of professionals in a challenging role and you possess the necessary qualifications please follow the instructions for applying on-line via the Medavie Blue Cross Corporate web site by clicking on the link below.

 

Apply Now

We would like to thank all candidates for expressing interest. Please note only those selected for interviews will be contacted. No phone calls please.

Citizenship - Useful Information

Please indicate in your application the reason you are entitled to work in Canada: Canadian citizenship, permanent resident status or work permit.

Reliability screening will be required.

Medavie Blue Cross is an equal opportunity employer.