Claims Data Entry Clerk, Grid 9

1 week ago

Victoria, Canada Maximus Full time

Company Profile:
Maximus Canada is an industry leader in the provisioning of products and services to support the delivery of government services in North America and internationally. With operations across Canada and around the globe, Maximus provides innovative, practical and meaningful solutions to help government programs and services function more effectively and efficiently.

We are constantly assessing new technology, processes and methods of delivering services to the citizens of Canada. With our expertise in program information management, claims processing, contact centre services, document processing and information technology, we are positioned for significant growth.

Maximus Canada offers competitive market-based salaries, comprehensive employer-paid benefits and a defined-benefit pension plan or a Group RSP with employer-matching contributions, for eligible employees. Our people also get some great perks too, such as employee appreciation events throughout the year, along with a supportive results-oriented work environment.

**Job Description**:
**Department Overview**

On behalf of the B.C. government, Health Insurance BC (HIBC) administers medical coverage through the Medical Services Plan (MSP) and drug coverage through the PharmaCare and Fair PharmaCare programs. With a staff of ~280 unionized employees and 4 excluded managers, the HIBC Operations department delivers services measured by 20 SLRs and 29 SLOs via four teams:

- Customer Service (Contact Centre, Pharma Care Help Desk, Service Desk, Info Support, and Prosthetics and Orthotics)
- Document Operations (Document Management, Document Processing, Admin Review, and Correspondence Liaison Unit)
- Practitioner and Patient Services (Provider Programs, Benefit Services, Billing Support, and In Province and Out of Country Adjudication)
- Operational Support Services (Medical Services and Pharmaceutical Services Support, Production Control, Support Coordinators)

**Role Summary**

This position is responsible for various data entry, processing, filing and mailing duties in support of the registration and account maintenance of physicians and other medical practitioners eligible to participate in MSP.

**Key Responsibilities**
- **
Process claims documentation submitted by providers **in order to efficiently enter them into our adjudication system.
- ** Understand and comply to MAXIMUS, legislated and client** **policies** and work procedures accurately, 98% of the time to meet our _Quality_ SLR and to provide excellent customer service.
- ** Adhere to your work commitment and daily schedule 95% of the time** so that MAXIMUS can meet its business goals efficiently and reliably.
- ** Manage your interactions** with callers, clients and colleagues respectfully, collaboratively and professionally to contribute to a harmonious, productive work environment.

**Education and Experience**
- proficient knowledge of MS Office, Outlook, ability to operate standard office equipment

Understand the Principles of
- customer service
- plain language communication
- professional, pro-social inter-relations
- privacy and security of personal information

**Knowledge, Skills and Abilities**

**Systems Use** (B=basic A=advanced, E=expert)

MS Word**:B** Outlook**:B** Claims Entry System**:A** MaxImage**:B**
- **
Process claims documentation provided by providers.**
- validate information and documentation provided by providers, reject or accept claims and requests, as appropriate
- access claims rejected in the Edit & Eligibility process and determine the reason
- release (or not) personal information to 3rd Party Requesters
- enter data at a speed of at least 50 wpm with a 98% accuracy
- perform repetitive tasks
- use a computer for long periods of time
- **
Understand and comply to policies/procedures set by MAXIMUS, legislation and our clients.**
- comply to all regulations, policies and procedures, with mínimal intervention
- escalate work that is beyond the level you are assigned
- obtain required approvals from designated personnel
- document notes and actions, in our systems, that are clear, objective and useful to others
- utilize designated channels and systems for making recommendations, communicating, reporting, etc.
- report non-compliance of policies and procedures, regardless of the cause
- **
Adhere to your work commitment and daily schedule.**
- manage personal time with mínimal impact to work time
- track and update weekly/monthly schedule expectations, as they are relayed
- update your Scheduler/supervisor with changes to your schedule as soon as you are aware of them, and with consideration of our planning needs and the BCGEU Collective Agreement.
- perform the work you are assigned within the designated time
- report your time accurately, in the appropriate system, within deadlines
- **
Manage your interactions with callers, clients and colleagues respectfully, collaboratively and professionally to contribute to a harmonious, productiv

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