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Provider Relations Specialist
2 months ago
The 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 from pharmacy, medical supplies & equipment, mental health care, vision care, and dental providers for accuracy and completeness.
Key Responsibilities- Validate completed provider agreements and return 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, visions 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 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
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment.
We provide Active PharmacyTM services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.
It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.
We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.