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Provider Services Claims Expert

2 months ago


Edmonton, Alberta, Canada Alberta Blue Cross Full time

About Alberta Blue Cross

Alberta Blue Cross is a leading health insurance provider dedicated to delivering exceptional customer experience and community leadership. We're committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness.

Our Values

We value diversity, encourage our employees to maintain a healthy work-life balance, and provide opportunities for career growth. Our team is passionate about making a difference in the lives of our members and the communities we serve.

Job Summary

We're seeking a temporary (18-month) Claims Coordinator to join our Provider Services team. The successful candidate will be responsible for ensuring that claims are accurately and efficiently managed, including the entry and adjudication of dental claims and treatment plans.

Key Responsibilities

  • Enter and manage dental claims and treatment plans to ensure timely payment for our providers and members.
  • Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance is required.
  • Contact providers to obtain necessary information to assess claims.
  • Adjudicate claims in accordance with Dental Services policies and standards with a high degree of accuracy and efficiency.
  • Monitor individual production to ensure that claim turnaround expectations are met.
  • Make suggestions to improve workflows and processes.

Requirements

  • Knowledge of dental terminology and nomenclature is a definite asset.
  • Demonstrated excellence in accuracy and multi-tasking under tight time frames and heavy workload.
  • Demonstrated ability to work with minimal supervision and within a team environment.
  • Demonstrated problem-solving and decision-making capabilities as well as strong organizational skills.
  • Strong attention to detail and a desire for continuous learning.
  • Proficiency with Microsoft Office Suite is required.

About the Role

This is an exciting opportunity to join a dynamic team and contribute to the success of Alberta Blue Cross. If you have the skills and experience we're looking for, please apply.