Case Management Coordinator
2 weeks ago
At Alberta Blue Cross, we are seeking a highly skilled Case Management Coordinator to join our team. This temporary (12-month) position will be responsible for claim intake and maintenance, including policy and benefit coverage validation, systems maintenance, and coordination and communication with internal and external stakeholders.
Key Responsibilities:
- Ensure forms are filed appropriately and kept confidential.
- Phone queue claim intake and status support.
- Authentication of claimants and external parties to ensure adherence to privacy guidelines.
- Creates claim intakes on adjudication system, and other report systems as required.
- Coordinates with Group Administration to enroll members in their benefits.
- Contacts and follows up as required with employers, plan members, beneficiaries, and physicians to obtain required information.
- Manage and upload all incoming correspondences, forms, and relevant documentation for claims adjudication or maintenance.
- Validates member information, census, salary, and eligibility information.
- Setup required tasking on claim for support of claim intake and maintenance.
- Prepares confidential correspondence for employers, members, physicians, treatment providers, lawyers, and other stakeholders.
- Updates claim, throughout its lifecycle in claims adjudication system, including but not limited to Access and FINEOS.
- Gather relevant documentation for case file assembly as it relates to referrals, litigation, or subrogation requests.
- Work collaboratively with Case Managers, Adjudicators and Payment Specialists with CCPD recoveries; including but not limited to creation of initial package, follow up and letters.
- Communicate with internal departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, and Payment team to provide and exchange information regarding claims activities, eligibility, and financial transactions.
Requirements:
- Related post-secondary education.
- Must possess excellent knowledge and experience with Microsoft Word, Access, Excel, and PowerPoint.
- Keen attention to detail.
- Strong analytical skills.
- Must possess excellent verbal and written communication skills.
- Must demonstrate strong organizational skills.
- Must be able to work well under pressure and be able to assess priorities in a confident manner.
- Must be flexible, innovative and independent.
- Must work effectively with fellow employees and staff from other departments in a team focused atmosphere.
- Must demonstrate excellent interpersonal skills.
- Experience with database management is an advantage.
Alberta Blue Cross is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our employees by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.
We offer a competitive salary and benefits package and the opportunity to work in an innovative, high-energy team-focused environment.
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