Clerk 3 Non-resident Outpatient Claim Coordinator

4 months ago

Halifax, Canada Province of Nova Scotia Full time

**Department**:Health and Wellness

**Location**:HALIFAX

**Type of Employment**:Term

**Union Status**:NSGEU - NSPG

**Closing Date**:11-Mar-24 (Applications are accepted until 11:59 PM Atlantic Time)

**About Us**:
The Department of Health and Wellness offers opportunities to grow and advance in a dynamic sector that touches the lives of all Nova Scotians. Along with our partners, including the Nova Scotia Health Authority and the IWK Health Centre, we’re committed to continually improving our health care system. With a focus on collaborative primary health care, improved supports for mental health and addictions, digital health, capital infrastructure, and more, the department is thinking differently about how to plan, fund, legislate and monitor to improve access and service delivery. To do this, we need leaders at all levels of the organization who embrace a challenge and believe in their ability to make a difference.

**About Our Opportunity**:
Under the direction of the Manager, Insured Services, the Non-Resident Outpatient (NROP) Claims Coordinator is responsible for administering, receiving, processing, and paying Nova Scotia hospitals for all non-Nova Scotian outpatient visits and for billing the provinces and territories for those patient visits. This position is also responsible for processing adjustments and responding to all inquiries from other jurisdictions or hospitals regarding each billing.

**Primary Accountabilities**:
Key Responsibilities include:

- Gathers, uploads, processes, and bills NROP claims in the Medigent Reciprocal Billing System for outpatient services received in Nova Scotia for residents of other provinces/territories. Prepares billing to all jurisdictions that must be in balance with a corresponding payment to the Nova Scotia hospitals that provided the service.
- Ensures payments are received and manages all requests for adjustments within the expected timelines including accountability to respond to all related inquiries. Prepare invoices requesting payment of outpatient reciprocal claims from provinces/territories. Generates various documents (statements, letters, backup info) to accompany billings.
- Prepares cheque requisitions for reimbursement of outpatient reciprocal claims to Nova Scotia hospitals. Posts all cheques issued in the Medigent billing system.
- Generates specific statements, letters, and cancellation list for each Nova Scotia Hospital that accompanies the payment of the outpatient monthly billing.
- Prepares various reports as required, maintains records, and maintains an accurate and up to date filing system.
- Responds to inquiries from provinces, hospitals and patients regarding coverage and eligibility.

**Qualifications and Experience**:

- Prior experience in billing, processing claims, or working with medical billing systems is essential.
- Familiarity with reciprocal billing processes and understanding of outpatient services would be an advantage.
- Strong attention to detail is crucial for accurately preparing invoices, managing payments, and maintaining records.
- Ability to spot discrepancies and ensure billing accuracy is essential.
- Must have excellent communication, interpersonal skills; along with excellent data entry skills to maintain demands of the role.
- Must be able to work effectively independently and as a team member.
- The role involves handling multiple tasks, documents, and deadlines. Organizational skills are vital for managing billing records and cheques.
- Maintaining an up-to-date filing system requires good organizational abilities.
- Understanding of financial processes, including cheque requisition, reimbursement, and financial statements, is beneficial.
- Experience handling inquiries from hospitals and patients is an asset.
- Complete confidentiality of all claim information must be maintained.
- Knowledge and experience Microsoft Outlook, Word, and Excel, Internet Explorer, Adobe PDF, MOVEit, and the Medigent reciprocal claim processing system will be considered assets.

**Equivalency**:
Include, but not limited to:

- Three years of undergraduate study in addition to one year of related experience
- A two-year certificate/diploma plus two years of related experience
- A one-year certificate/diploma plus three years of related experience

**Benefits**:
The Government of Nova Scotia offers its employees a wide range of benefits such as Health, Dental, Life Insurance, Pension, General Illness (Short and Long Term), Vacation and Employee and Family Assistance Programs. Click here to learn more about our various benefits offering and eligibility criteria.

**Working Conditions**:

- Normal work week is 35 hours/week, 7 hours/day
- May be required to work overtime on occasion

**Additional Information**:
**What We Offer**:

- Career development where you have access to career guidance, tools, resources, and ongoing training for every stage of your career
- Engaging workplace: our employees feel valued, respected, c

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