Provider Relations Specialist
1 month ago
The Credentialing Lead Representative is a Band 2 Professional Career Track Role.
We value our talented employees and strive to help them grow professionally before recruiting new talent to our open positions.
Our people make all the difference in our success.
Role OverviewThe Provider Relations Representative will review network agreements from pharmacy, medical supplies & equipment, mental health care, vision care, and dental providers for accuracy and completeness.
The successful incumbent will ensure that all providers' pertinent information is correctly entered into the Express Scripts Canada system.
Key Responsibilities- Validate completed provider agreements and return them to providers for further review and modifications if information is missing.
- Ensure that all pharmacy, medical supplies & equipment, and dental providers' required agreement information is entered into the Express Scripts Canada System in a timely manner.
- Ensure that all pharmacy, medical supplies & equipment, mental health care, vision care, and dental providers' modifications and terminations are updated in a timely manner.
- Handle provider, association, and software vendor inquiries in a supportive and professional manner.
- Collaborate with teammates and assist in other team deliverables as required.
- 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 the ability to work independently with minimal 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 self-motivation to grasp new concepts quickly.
- Ability to analyze, problem-solve, and mediate difficult situations.
- Results-oriented, paying attention to detail.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
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Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Provider Relations RepresentativeThe role of Provider Relations is to ensure seamless claims adjudication and payment by delivering effective and timely communications to healthcare providers.About the RoleWe are seeking a Provider Relations Representative to work from our Mississauga office. The successful incumbent will review network agreements...
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