Audit Investigator

2 weeks ago

Charlottetown, Prince Edward Island, Canada Medavie Blue Cross Full time

For over 75 years, Medavie Blue Cross has been a key player in the health and wellness landscape, partnering with individuals, businesses, and governments throughout Canada. As a not-for-profit entity, we invest in communities to tackle some of the nation's most critical healthcare issues. We take pride in being recognized as one of Canada's Most Admired Corporate Cultures, Top 100 Employers, Life & Health Insurer of the Year 2021, and a Caring Company certified by Imagine Canada.

Our team of 2,400 professionals operates across six provinces, sharing core values of compassion, accountability, innovation, and community focus. Our mission is to create an environment where our employees can flourish through programs that support health, well-being, and personal and professional development.

Job Title: Audit Investigator
Department: Finance and Treasurer
Competition: 87131
Internal/External: Both
Employment Type: Full Time Permanent
Location: Remote in Atlantic Canada or Ontario
Salary: Competitive Compensation Package
Reports To: Team Leader

The Opportunity

We have an exciting opportunity for a proactive individual to join our Federal Provider Audit unit as an Audit Investigator. In this role, you will be responsible for identifying irregular claiming patterns among healthcare providers in our drug, hospital, extended-health, and dental benefit programs. Effective communication with service providers and customers is a key aspect of this position.

Key Responsibilities

  • Planning, executing, and overseeing claims audits and investigative projects following industry best-practices;
  • Utilizing analytical tools to detect anomalies in claims submissions by healthcare providers;
  • Conducting audits of providers and members, making recommendations based on findings, and preparing finalized reports for management and regulatory bodies;
  • Summarizing findings and proposed solutions in detailed reports;
  • Building strong relationships with colleagues and customers to promote collaboration and problem-solving;
  • Continuous learning and skill development in audit best-practices and industry knowledge;
  • Leading and participating in risk-based projects;
  • Occasional travel within Canada for on-site audits.

Qualifications

  • Experience in auditing or investigative practices, preferably 1-3+ years;
  • Relevant post-secondary education and a fraud detection or auditing professional designation;
  • Proficiency in data analytics software and statistical inference;
  • Strong problem-solving and team collaboration skills;
  • Effective communication skills, both written and verbal;
  • Ability to manage multiple priorities and deadlines;
  • Computer proficiency and financial services background, especially in insurance and healthcare sectors;
  • Healthcare field experience would be a bonus;
  • Willingness to travel in Canada with a valid driver's license.

  • Loss Prevention Agent

    2 weeks ago

    Charlottetown, Prince Edward Island, Canada LVMH Group Full time

    Job ID: 243105Location: PE-Charlottetown (1548)Address: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA)Full Time/Part Time: Full TimePosition Type: RegularThe Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce shortage.ESSENTIAL DUTIES AND...

  • Quality System Administration Associate

    1 month ago

    Charlottetown, Prince Edward Island, Canada BioVectra Inc. Full time

    Quality System Administration Associate Charlottetown, PE, Canada Req #1530 Wednesday, May 15, BIOVECTRA Inc. is a leading bio-science business in Prince Edward Island and Nova Scotia, focused on contract manufacturing and product development of active pharmaceutical ingredients, pharmaceutical intermediates, and bioreagents. BIOVECTRA Inc. has opening...

  • Senior Accountant

    2 weeks ago

    Charlottetown, Prince Edward Island, Canada BioVectra Inc. Full time

    Senior Accountant Charlottetown, PE, Canada Req #1534 Thursday, May 23, BIOVECTRA Inc. is a leading bio-science business in Prince Edward Island and Nova Scotia, focused on contract manufacturing and product development of active pharmaceutical ingredients, pharmaceutical intermediates, and bioreagents. BIOVECTRA Inc. has an opening for a Senior...

  • Senior Accountant

    1 month ago

    Charlottetown, Prince Edward Island, Canada BioVectra Inc. Full time

    Senior Accountant Charlottetown, PE, Canada Req #1534 Thursday, May 23, BIOVECTRA Inc. is a leading bio-science business in Prince Edward Island and Nova Scotia, focused on contract manufacturing and product development of active pharmaceutical ingredients, pharmaceutical intermediates, and bioreagents. BIOVECTRA Inc. has an opening for a Senior...

  • Los Prevention

    1 week ago

    Charlottetown, Canada Kent Building Supplies Full time

    Overview: We are seeking a Loss Prevention professional to join our team. As a Loss Prevention Specialist, you will play a crucial role in protecting our company's assets and minimizing losses. This position requires strong attention to detail, excellent communication skills, and the ability to educate and train others on loss prevention strategies. Duties:...

  • Accounts Receivable Clerk

    1 month ago

    Charlottetown, Canada Next Level Group Full time

    Job Description:We are seeking a skilled individual to join our team as an Accounts Receivable Billing Clerk. In this role, you will play a crucial part in ensuring the accurate and efficient functioning of our departmental operations. Your primary focus will be on maintaining and processing accounts receivable transactions, while also ensuring that customer...

  • Loss Prevention Agent

    1 week ago

    Charlottetown, Canada Sephora Full time

    **Job ID**: 243105 **Location**: PE-Charlottetown (1548) **Address**: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA) **Full Time/Part Time**: Full Time **Position Type**: Regular The Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce...

  • Quality System Administration Associate

    3 weeks ago

    Charlottetown, Canada BioVectra Inc. Full time

    Charlottetown, PE, Canada Req #1530 Wednesday, May 15, 2024 BIOVECTRA Inc. is a leading bio-science business in Prince Edward Island and Nova Scotia, focused on contract manufacturing and product development of active pharmaceutical ingredients, pharmaceutical intermediates, and bioreagents. BIOVECTRA Inc. has opening for Quality System Administration...

  • Loss Prevention Agent

    1 month ago

    Charlottetown, Canada Sephora Full time

    Job ID: 243105 Location: PE-Charlottetown (1548) Address: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA) Full Time/Part Time: Full Time Position Type: Regular The Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce shortage. ESSENTIAL DUTIES AND...

  • Loss Prevention Agent

    1 month ago

    Charlottetown, Canada Sephora Full time

    Job ID: 243105 Location: PE-Charlottetown (1548) Address: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA) Full Time/Part Time: Full TimePosition Type: RegularThe Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce shortage. ESSENTIAL DUTIES AND...

  • Loss Prevention Agent

    1 month ago

    Charlottetown, Canada Sephora USA, Inc Full time

    Job ID: 243105Location: PE-Charlottetown (1548)Address: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA)Full Time/Part Time: Full TimePosition Type: RegularThe Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce shortage.ESSENTIAL DUTIES AND...

  • Loss Prevention Agent

    1 month ago

    Charlottetown, Canada Sephora USA, Inc Full time

    Job ID: 243105Location: PE-Charlottetown (1548)Address: 670 University Ave Unit 15, Charlottetown, PE C1E 1H6, Canada (CA)Full Time/Part Time: Full TimePosition Type: RegularThe Loss Prevention Agent protects the assets of a store against theft, and works with the Leadership team to maintain operational controls to reduce shortage.ESSENTIAL DUTIES AND...

  • Asset protection representative

    1 week ago

    Charlottetown, Canada Loblaw Companies Ltd - Head Office Full time

    Les candidats référés ne doivent pas postuler directement pour ce poste. Toutes les références de candidats doivent d’abord être soumises dans Workday par un collègue de Loblaw actuel.L’utilisation du masculin à pour but d’alléger le texteVenez faire votre différence dans les communautés à travers le Canada, où l'authenticité, la...

  • Asset protection representative

    6 days ago

    Charlottetown, Canada Loblaw Companies Ltd - Head Office Full time

    Les candidats référés ne doivent pas postuler directement pour ce poste. Toutes les références de candidats doivent d’abord être soumises dans Workday par un collègue de Loblaw actuel.L’utilisation du masculin à pour but d’alléger le texteVenez faire votre différence dans les communautés à travers le Canada, où l'authenticité, la...