Claims Specialist

2 weeks ago

Toronto, Canada Bell Full time

Req Id: 417866

At Bell, we do more than build world-class networks, develop innovative services and create original multiplatform media content - we advance how Canadians connect with each other and the world.

If you’re ready to bring game-changing ideas to life and join a community that values professional growth and employee wellness, we want you on the Bell team.

Our Bell Business Markets team enables the digital transformation of businesses and governments nationwide through solutions in areas including Internet and private networks, voice and unified communications, contact centre, security, Internet of Things, data centre and cloud. We’re proud to be Canada’s leading provider of broadband network and communication services for businesses and governments.

Bell (and predecessors) has won and maintained the contract to support the Newfoundland and Labrador Prescription Drug Program (NLPDP) since 1994 for the Government of Newfoundland and Labrador. the Department of Health and Community Services—specifically its Pharmaceutical Services Division (PSD) —must assess citizens' needs in a timely, accurate and cost-effective manner. The Division strives to serve citizens fairly and efficiently while controlling operational costs and providing pharmacies with the assurance that beneficiaries' coverage information is correct when drugs are dispensed.

Bell is seeking a Claims Specialist to join the team involved in the processing of provider and beneficiary claims and other duties to help fulfil the prescription drug need for those who qualify under NLPDP.

**Key Responsibilities**:

- Process beneficiary (resident) receipts, issuing letters when necessary for various programs including out of province claims
- Update the Medigent system daily or as required with current information relating to prescribers, e.g. doctors; nurses; dentists; optometrists; pharmacists and new pharmacy openings as per direction from the various boards
- Respond to telephone inquiries from residents, pharmacists, PSD, etc. providing responses or redirection as required.
- Complete Price and Audit Adjustments
- Maintain and reconcile cheques and bank statements
- May also require:

- Prepare and post bulletins
- Maintain the monthly DIN load process
- Complete payment
- Analyze, coordinate and follow up on short stocks
- Analyze and update DINs/PINs
- Execute the formulary and supplement activities
- Liaise with team members, technical team, PSD, and other stakeholders to ensure commitments are met and results are accurate

**Critical Qualifications**:

- Minimum 1 year program in Business Administration Program or 1-2 years experience in an administrative environment
- Experience with Word; Excel; MS Office Products
- Experience dealing with the public on requests and issues
- Experience processing insurance claims would be an asset
- Knowledge of medical terminology would be an asset

EmployeeReferralProgram

Adequate knowledge of French is required for positions in Quebec.

**Additional Information**:
**Position Type**:Management
**Job Status**:Regular - Full Time
**Job Location**:Canada : Newfoundland : Mount Pearl
**Work Arrangement**: Hybrid
**Application Deadline**:05/13/2024

Created: Canada, ON, Toronto

**Bell, one of **Canada's Top 100 Employers.

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