Alternate Funding Program

For over 75 years, Medavie Blue Cross has been a leading health and wellness partner for individuals, employers and governments across Canada. As a not-for-profit organization, we proudly invest in communities to help address some of Canada’s most pressing health care challenges. We are one of Canada's Most Admired Corporate Cultures, one of Canada’s Top 100 Employers, Canada’s Life & Health Insurer of the Year for 2021 and an Imagine Canada Caring Company. 
 
Our 2,400 professionals work across six provinces, united by our shared values of being caring, accountable, responsible, innovative and community-minded. We’re committed to ensuring our employees thrive in our award-winning, collaborative culture focused on ensuring health, wellness, and personal and professional growth through a variety of programs and support across our organization.
 
Together with Medavie Health Services, we are part of Medavie — a national health solutions partner with over 8,250 employees. Our mission is to improve the wellbeing of Canadians.

Reporting to the Team Leader and working in a team environment, the claims analyst is responsible for a wide variety of claim types under the Alternate Funding Program.  Each claim type has a varying degree of eligibility and policy requirements.  The claims analyst will analyze, investigate and pay claims which include the payment of locum, sessional, psychiatry and various other claims on an ad hoc basis.  

The claims analyst is required to maintain current knowledge with respect to policy and procedure changes.  The claims analyst will liaise closely with the Department of Health and Wellness, physicians, colleagues, the Team Leader and the Manager on claims as they pertain to the Alternate Funding Program.

Key Responsibilities

•    Review, analyse and set up payment data based on contracts forwarded from the Department of Health & Wellness.
•    Maintain and reconcile contract payments to physicians using standard procedures.
•    Adjudicate and apply data entry functions for all alternate funding programs and billings from physicians with a strong emphasis on accuracy and efficiency.
•    Review applications from the Boarding, Transportation and Ostomy Program as well as the Locum Program to determine eligibility
•    Respond to customer enquiries in a prompt, courteous and professional manner.
•    Meet payment deadlines as determined by the business area
•    Liaise with the Department of Health and Wellness and physicians in a professional manner with respect to claims submissions and payment reconciliations.
•    Establish and maintain effective working relationships with other internal operational areas

Required Qualifications 

Education: Post-secondary education in Business Administration, Accounting, Finance or other related field.

Work Experience: 2 - 3 years of relevant experience would be an asset.

Other Qualifications: Able to adapt in a changing and fast paced environment with the ability to accept and implement changes; able to work independently.  Possess a high attention to detail and a high level of accuracy; analytical in nature and have proven problem solving skills with an aptitude for mathematics.

Computer Skills: Strong computer skills and experience working with the Microsoft Office Suite and Lotus Notes; strong key boarding skills and the ability to enter data with speed and precision.

Language Skills: Bilingualism is considered an asset

Core Competencies

Knowledge: Strong knowledge and/or experience within a Business/Finance environment. Knowledgeable about the department, it's customers, policies and procedures and how they apply in the job. 
     
Analytical Thinking: Develop the business knowledge and experience required to solve routine problems. Ask questions to determine the source of the problem. Discuss possible solutions and make suggestions. 

Communication Skills: Excellent communication skills by way of verbal, written, and electronic medium. Listens to directions and instruction with the ablitiy to accurately restate them to ensure full understanding. 

Customer Orientation: Seeks information about internal and external customers and their business needs to ensure these needs are met with a commitment to excellence and quality in customer service delivery. 

Execution and Organizational Skills: High level of accuracy with attention to details while maintaining the abilty to complete assigned tasks and meet deadlines. Ability to set and work through list of priorities in a timely manner.

Team Work:Demonstrates a willingness to learn, while working collaboratively to achieve common goals by asking for feedback, sharing information and encouraging others to share information

We are an Equal Opportunity Employer. 

Medavie Blue Cross strives to foster a culture where everyone is enabled to achieve their full potential - a culture of diversity, equity and inclusion (DEI) where we live our values every day in the way we treat each other, our members and the communities we serve. Accessibility is a top priority.

For applicants with disabilities, we provide accommodations throughout the recruitment, selection and/or assessment process. If selected to participate in the recruitment, selection and/or assessment process, please inform Medavie Blue Cross Human Resources staff of the nature of any accommodation(s) that you may require in respect of any materials or processes used to ensure your equal participation. All personal information is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act.

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