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Provider Relations Representative

3 months ago

Montreal, Quebec, Canada The Cigna Group Full time

The role of Provider Relations is to accurately register healthcare providers and maintain a current database in order to support providers by delivering effective and timely communications to ensure seamless claims adjudication and claims payment.


The successful incumbent will review network agreements from pharmacy, medical supplies & equipment, mental health care, vision care, and dental providers for accuracy and completeness and ensure that all providers' pertinent information is correctly entered into the Express Scripts Canada system.




NOTE:

This is an on-site position Part-time ( 21 hours per week) contract position working out of Mississauga or Montreal Head Office.



Key Responsibilities

  • Validates completed provider agreements and returns to providers for further review and modifications if information is missing
  • Ensures that all pharmacy, medical supplies & equipment and dental providers' required agreement information is entered into the Express Scripts Canada System in a timely manner
  • Ensures that all pharmacy, medical supplies & equipment, mental health care, visions care, and dental providers' modifications and terminations are updated in a timely manner
  • Handles provider, association and software vendor inquiries in a supportive and professional manner
  • Collaborates with teammates and assists in other team deliverables as required

Qualifications

  • Post-Secondary school diploma
  • Bilingual an asset (French & English)
  • Excellent written, and verbal communication skills
  • Knowledge of healthcare/pharmacy, medical supplies & equipment or dental benefit administration and claims processing is an advantage
  • Strong customer service focus understanding the Express Way Values
  • Computer literate, possessing intermediate skills in MS Office (Word, Excel, Outlook), and Adobe Reader and Writer
  • Strong interpersonal skills with ability to work independently with mínimal supervision; and as a team player willing to take direction
  • Flexible to new situations and adaptable to change
  • A thorough understanding of quality assurance and delivery of service excellence
  • Excellent organizational skills, effective time management, and the ability to shift priorities working within established timelines
  • Demonstrates initiative (learn processes and procedures, various benefits) and displays selfmotivation to grasp new concepts quickly
  • Ability to analyze, problemsolve and mediate difficult situations
  • Resultsoriented paying attention to detail.

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 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.


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.