Prevention and Detection Assesor

3 days ago

Ottawa, Canada Cowan Insurance Group Full time

The Prevention and Detection Assessor, reporting to the Manager, TPA Claims will be responsible for conducting audits for client of Cowan Insurance and will assist with Provider Profiling and Auditing.

**What you will do**:

- Conduct Audits by reviewing healthcare provider claims, medical records, and billing information to ensure accuracy and compliance with applicable regulations.
- Identify discrepancies, errors, potential fraud in billing and coding practices.
- Prepare detailed reports summarizing all audit findings, including billing patterns, issues, errors, and potential abuse.
- Provide recommendations for correcting errs and preventing future issues.
- Stay updated on provincial healthcare regulations and respective changes to provincial medical plans
- Responsible for Provider Profiling, including new and existing providers.
- Establishing clear guidelines for acceptable provincial billing practices.

**What you will bring**:

- Completion of post secondary university/diploma or equivalent
- Strong knowledge/experience in the provincial health care system
- 3-5 years experience in clinical/medical office environment
- Certified OHIP Billing, is an asset (willingless to work towards)
- Bilingualism, English and French, is an asset

**Who we are**:
Proudly independent and Canadian-owned, Cowan Insurance Group has been a true market leader in the insurance industry since 1927. With an extensive range of product offerings and integrated commercial and personal insurance, group benefits, and wealth management solutions, we provide our clients with outstanding customized, comprehensive insurance and risk management professional advice and placement.

Recognized as one of Canada's Most Admired Cultures and a Canada's Best Managed Companies Platinum Club Member, Cowan Insurance Group's award-winning client-centric approach emphasizes innovation, excellence, and collaboration. Join our team as we prepare for our centennial celebration in 2027

**What sets us apart?**

**Be in good company**

Integrity matters. It drives our award-winning workplace culture and fuels our collective desire to help our clients, employees, and communities thrive.

**Challenge your thinking**

You're valued for your passion, drive and creativity. The pace is fast but the work is meaningful, interesting, and complex, just the way you like it.

**Grow together**

We believe in your potential. If you’re looking to develop your expertise with learning opportunities and mentoring, we’ll make that happen.

**Benefits and perks**
- Competitive salary
- Participate in our comprehensive benefits plan on day one — no waiting period
- Company-matched Retirement Savings Plan
- Company-paid training and development courses
- Community involvement
- Hybrid work environment

**Are you interested?**

Please Apply

While we appreciate the interest of all applicants, we will contact only those selected for interviews. If you are an applicant with disabilities and require accommodations, please let us know at the time of our contact so that we may arrange for their provision.

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