Job Description

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\xe2\x80\x99s most pressing health care challenges. We are one of Canada\'s Most Admired Corporate Cultures, one of Canada\xe2\x80\x99s Top 100 Employers, Canada\xe2\x80\x99s 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\xe2\x80\x99re 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 \xe2\x80\x94 a national health solutions partner with over 7,200 employees. Our mission is to improve the wellbeing of Canadians.



Job Title:
Claims Analyst


Department:
Government


Competition:
85460


Internal/External:
Both


Employment Type:
Full Time Permanent


Location:
Dartmouth Office, Work from home, or Hybrid of both locations


Salary:
Competitive Compensation


Reports To:
Team Leader




Position Summary
Reporting to the Team Leader, and working in a team environment, the Claims Analyst is responsible for a wide variety of complex medical claims from multiple programs with varying degrees of eligibility and policy requirements. Using an online system, the Claims Analyst will assess, analyze, investigate and pay medical claims, including paper submissions of out-of-province and/or out-of-country claims, and special programs. The Claims Analyst is required to maintain current knowledge with respect to policy and procedure changes. The Claims Analyst will liaise closely with the MSI Medical Consultant, fellow staff, the Team Leader and the Manager on claims as they pertain to insured medical services.


This position is daytime core business hours, Monday- Friday and has the fliexiblity to work from a home based office within the province of Nova Scotia.


Key Responsibilities

• Review, analysis, and appropriate payment of complex claims specifically; medical, optometry, nurse practitioner, out of province, out of country, special consideration, and exceptional circumstances in an accurate and efficient manner with high attention to detail on a daily basis
• Decipher detailed operative reports, record of operation and record of anesthesia, 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.
• Provide excellent customer service when answering incoming phone calls and email enquiries.

Required Qualifications
Education: Post secondary education in a health related field
Work Experience: a minimum of 2 -3 years of related work experience.
Other Qualifications: Able to adapt in a changing and fast paced environment with the ability to accept and implement changes; able to work independently. Knowledge of and or experience with physician billing in Nova Scotia considered an asset.
Computer Skills: Strong computer skills and experience working with the Microsoft Office Suite especially Microsoft Excel; comfortable with information technology systems from a business user perspective. Efficient keyboarding and word processing skills.
Language Skills: Bilingualism would be considered an asset, English is a requirement


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.

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