Job Description

Express Scripts Canada has an exciting opportunity for a

Dentist

who is looking to expand their career to use their analytical and investigative skills along with their practice and knowledge of benefit coverage. This part-time role in the Business Integrity team enhances the Express Scripts Canada (ESC) value proposition for customers to ensure the integrity of health claims while maintaining a network of providers through diligent review and education.

NOTE: This position includes travelling (25%) across Canada.

This is a 12 months contract with a strong possibility of extension.

Key Responsibilities:

Review provider claims reports to identify abnormal or inconsistent claims submissions Perform on-site audits at the provider's location in Canada Review & summarize findings from provider chart/clinical notes, radiographs, lab bills, etc. Review audit reports for quality, accuracy, and proper audit application Provide clinical opinion to support audit specialists Participate as required in peer reviews with external clients Consult with internal and external stakeholders regarding audit activities Continuously review and provide recommendations regarding claims verification risk criteria

Qualifications:

Minimum of 5 years of recent and demonstrated experience within a dental office environment Current registration with a provincial college Ability to manage confidential information Strong focus on quality and accuracy Detail-oriented with proven high-level oral and written communication skills Demonstrates and applies integrity in all aspects of work Excellent time management and organizational skills Knowledge of Microsoft Office software (Word, Excel and PowerPoint) Bilingualism (French & English) is required.

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Express Scripts Canada offre une occasion de carriere ideale a un

dentiste

qui souhaite elargir ses horizons professionnels en utilisant ses competences en matiere d'analyse et d'enquete ainsi que ses connaissances en assurance collective. Le poste de dentiste-conseil a temps partiel au sein du Service d'integrite des pratiques d'affaires consiste a offrir des services a valeur ajoutee aux clients d'Express Scripts Canada. Le dentiste-conseil doit veiller a l'integrite des demandes de reglement pour soins dentaires et s'assurer que l'entreprise conserve un solide reseau de fournisseurs grace a des examens diligents et a des conseils.

Responsabilites principales

Reviser les rapports sur les demandes de reglement afin de deceler les demandes de reglement qui presentent des anomalies ou des incoherences. Effectuer des audits sur place, dans des cabinets dentaires au Canada. Examiner les notes consignees aux dossiers des patients, les radiographies, les factures de laboratoire et resumer ses constatations. Examiner les rapports d'audit afin d'en assurer la qualite et l'exactitude et de confirmer que le processus d'audit a bien ete suivi. Donner une opinion professionnelle afin d'apporter du soutien aux specialistes des audits. Participer a des revisions par les pairs, au besoin, avec les clients a l'externe. Discuter des activites d'audit avec les intervenants a l'interne et a l'externe. Reviser les criteres de risque relatifs a la verification des demandes de reglement et faire des recommandations.

Qualification

Posseder cinq annees d'experience recente dans un cabinet dentaire. Etre membre d'une association dentaire provinciale. Etre en mesure de gerer des renseignements confidentiels. Mettre l'accent sur la qualite et l'exactitude. Etre minutieux et posseder d'excellentes habiletes de communication a l'oral comme a l'ecrit. Faire preuve d'integrite dans tous les aspects de son travail. Posseder d'excellentes aptitudes en gestion du temps et avoir un bon sens de l'organisation. Connaitre les logiciels de la suite Microsoft Office (Word, Excel et PowerPoint) Etre bilingue (francais et anglais), a l'oral comme a l'ecrit.

Note: Internal posting will be closed on October 13, 2025

Express Scripts Canada is a Cigna company

Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.

About Express Scripts Canada

Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active Pharmacy(TM) services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.


It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.


We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.


We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.


We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.


If you require accommodation in completing the online application process, please email: eschr2@express-scripts.com Do not email eschr2@express-scripts.com for an update on your application or to provide your resume as you will not receive a response.