Claims Analyst

2 weeks ago

Nova Scotia, Canada Medavie Blue Cross Full time

Medavie Blue Cross is seeking a Claims Analyst to join our team in the Alternate Funding Program. As a Claims Analyst, you will be responsible for analyzing, investigating, and paying claims under the Alternate Funding Program. This includes reviewing and setting up payment data based on contracts forwarded from the Department of Health & Wellness, maintaining and reconciling contract payments to physicians, and adjudicating and applying data entry functions for all alternate funding programs and billings from physicians.

Key Responsibilities


Review and analyze payment data based on contracts forwarded from the Department of Health & Wellness.

Maintain and reconcile contract payments to physicians using standard procedures.

Adjudicate and apply data entry functions for all alternate funding programs and billings from physicians with a strong emphasis on accuracy and efficiency.

Review applications from the Boarding, Transportation, and Ostomy Program as well as the Locum Program to determine eligibility.

Respond to customer inquiries in a prompt, courteous, and professional manner.

Meet payment deadlines as determined by the business area.

Liaise with the Department of Health and Wellness and physicians in a professional manner with respect to claims submissions and payment reconciliations.

Establish and maintain effective working relationships with other internal operational areas.

Required Qualifications

Education: Post-secondary education in Business Administration, Accounting, Finance, or other related field.

Work Experience: 2-3 years of relevant experience would be an asset.

Other Qualifications: Able to adapt in a changing and fast-paced environment with the ability to accept and implement changes; able to work independently. Possess a high attention to detail and a high level of accuracy; analytical in nature and have proven problem-solving skills with an aptitude for mathematics.

Computer Skills: Strong computer skills and experience working with the Microsoft Office Suite and Lotus Notes; strong keyboarding skills and the ability to enter data with speed and precision.

Language Skills: Bilingualism is considered an asset.

Core Competencies

Knowledge: Strong knowledge and/or experience within a Business/Finance environment. Knowledgeable about the department, its customers, policies, and procedures and how they apply in the job.

Communication Skills: Excellent communication skills by way of verbal, written, and electronic medium. Listens to directions and instruction with the ability to accurately restate them to ensure full understanding.

Customer Orientation: Seeks information about internal and external customers and their business needs to ensure these needs are met with a commitment to excellence and quality in customer service delivery.

Execution and Organizational Skills: High level of accuracy with attention to details while maintaining the ability to complete assigned tasks and meet deadlines. Ability to set and work through a list of priorities in a timely manner.

Team Work: Demonstrates a willingness to learn, while working collaboratively to achieve common goals by asking for feedback, sharing information, and encouraging others to share information.

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