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Claims Analyst

Posting Date: Nov 19, 2021

Location: Moncton, New Brunswick, CA, E1C 8L3

Company: Medavie Blue Cross

For over 75 years, Medavie Blue Cross has been a leading health and wellness partner for individuals, employers and governments across Canada. We are proud to be a not-for-profit organization dedicated to giving back to the communities where we live and work, and to ensuring our employees thrive in our award-winning, collaborative culture. We are one of Canada’s Most Admired Corporate Cultures and are recognized as a Caring Company, a designation for national leaders in community investment and social responsibility.

Our team of 2,100 professionals work across six provinces. We excel by living our shared values of being caring, accountable, responsible, innovative and community-minded. We’re committed to ensuring the health and wellness of our employees and their families, along with personal and professional growth, through a variety of programs and support at all levels of our organization.

 

Along with Medavie Health Services, we are part of Medavie — a national health organization with over 6,400 employees. Together, our mission is to improve the wellbeing of Canadians. 

 

Job Title: Claims Analyst  
Department: Provincial Programs  
Competition: 75207  
Internal/External: Internal/External  
Employment Type: Fulltime, Permanent  
Location: Moncton, NB  
Salary: Competitive Compensation  
Reports To: Team Leader  
Closing Date: December 5, 2021  

 

 

 

 

 

The Opportunity

 

As a Claims Analyst, you work with a wide variety of prescription drug claims with varying degree of eligibility and policy requirements.  You will aesses, analyze, investigate and pay 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 Consultants and the provincial programs team.

The hours of work are within core business hours of 8 a.m. – 5 p.m., Monday to Friday.

 

Key Responsibilities

•Review, analyze, investigate and authorize payment of claims within guidelines;

•Correspond with beneficiaries and providers my mail or phone;

•Produce various reports for finance and customer;

•Maintain tracking records;

•Organize work and information to ensure claims are paid accurately and efficiently;

•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;

•Provide advice and recommendations to People Leader regarding procedures development relating to policy changes requested by the Department of Health

•Adhere to the performance measures under the Service Level Agreement Contract;

 

The ideal candidate will possess:

 

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

Work Experience: 1 to 2 years relevant experience

Other Qualifications: Have strong organizational skills and a high level of accuracy.

Computer Skills: Experience workin 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.   

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

We would like to thank all candidates for expressing interest.  Please note only those selected for interviews will be contacted.

Medavie Blue Cross is an equal opportunity employer.

In order to keep our employees, candidates, and community safe during the COVID-19 pandemic, the majority of our employees are working from home within Canada. All interviewing, onboarding and most work takes place remotely at this time. For those employees who must work in our offices, we have taken every precaution to ensure the health and safety of our people by providing strict protocols/practices to meet legislated client and company needs, as well as modifications to the worksites to mitigate the risks for everyone's protection.

At Medavie, everything we do is to improve the wellbeing of Canadians.  We have implemented a COVID-19 Vaccination Policy as part of our ongoing efforts to protect the health and safety of our employees, partners, plan members and the communities where we live and work.  Proof of full vaccination is required to work onsite at any Medavie Workspace. 


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