Bilingual Client Benefit Analyst
6 days ago
The primary function of the Client Benefit Analyst is to act as a key point of contact for all Health Benefit inquiries and issues for our customers - insurance companies and third party administrators (TPAs). The Client Benefit Analyst will ensure that relationships with our customers are effectively maintained. The Customer Services team provides support to customers on Pharmacy, Dental and Health plans coverage. The team also provides customer support on various database, IT, adjudication inquiries, and coordinating with other departments to fully support customers
This position is open for our Head Office in Mississauga, ON and Montreal Head Office locations.
**ESSENTIAL FUNCTIONS**:
Provide expertise on Drug, Dental & Extended Health Benefits related issues as requested by customers, such as claim adjudication and payment questions.
Support ESC Clinical team with the implementation of new and existing clinical programs, formularies, and new business development products.
Provide support to Account Managers on various strategic initiatives, communications and promotion of ESI Canada’s products to the marketplace.
Support customers with impact analysis as needed.
Act as the liaison between the customer and other Express Scripts Canada departments which include; Drug Plan Management, DIN Database, Provider Audit, Information Systems, Claims Processing, Finance and Provider Call Centre. Work closely alongside these internal operational representatives to identify and resolve customer needs.
Facilitate and attend various meetings with customers and internal partners.
Provide back up to Customer Support Specialist
**QUALIFICATIONS**:
University Degree, College Diploma or Equivalent experience
Bilingual in French and English written and is required
Experience in the field of Group Insurance, Pharmacy, Dental or Health Benefits Plans
Pharmacy technician background and/or knowledge of government drug programs (Ontario Drug Benefits, Provincial Formularies, RAMQ) is an asset
Excellent Customer Service capabilities
Demonstrates strong analytical and critical thinking skills
Demonstrates leadership & problem solving skills
Ability to multitask and prioritize based on urgency
Able to work effectively with both internal/external customers and internal/external contacts
Excellent verbal and written communication skills
Analyste technique de régimes - Poste bilingue
L’analyste technique de régimes agit à titre de personne-ressource auprès de nos clients, des assureurs et des tiers administrateurs lorsqu’ils formulent des requêtes ou éprouvent des difficultés en matière de régimes de soins de santé. L’analyste technique de régimes s’assurera de maintenir d’excellentes relations avec les clients. L’équipe du Service à la clientèle fournit le soutien relatif à la couverture des régimes d’assurance médicaments, de soins dentaires et de soins médicaux complémentaires. Elle fournit également le soutien relativement à toute question liée aux bases de données, aux services informatiques et au traitement des demandes de règlement, et effectue la coordination avec d’autres services afin de soutenir pleinement les clients.
RESPONSABILITÉS PRINCIPALES
Fournir une expertise technique relativement aux questions des clients sur les régimes d’assurance médicaments, de soins dentaires et de soins médicaux complémentaires, ainsi que sur le traitement des demandes de règlement et les paiements.
Fournir le soutien à l’équipe des Services cliniques d’Express Scripts Canada relativement à la mise en place de programmes cliniques (nouveaux ou actuels), de listes de médicaments ainsi que de nouveaux produits en lien avec le développement des affaires.
Fournir le soutien aux chargés de comptes relativement aux divers projets stratégiques, aux communications et à la promotion de produits d’Express Scripts Canada sur le marché.
Fournir des analyses de répercussions aux clients, au besoin.
Agir à titre d’agent de liaison entre les clients et d’autres services au sein d’Express Scripts Canada, Et travailler en étroite collaboration avec ces services pour déterminer les besoins des clients et y répondre.
Organiser diverses réunions avec les clients et les collaborateurs internes et y participer.
Fournir un appui aux spécialistes du soutien à la clientèle (Centre d’appels).
COMPÉTENCES RECHERCHÉES
Être titulaire d’un diplôme universitaire ou collégial, ou posséder l’expérience équivalente.
Posséder une excellent maitrise du français (oral et écrit)
Posséder de l’expérience dans le domaine de l’assurance collective, des régimes d’assurance médicaments, de soins dentaires ou de soins médicaux complémentaires.
Posséder de l’expérience à titre de technicien en pharmacie ou des connaissances des régimes provinciaux d’assurance médicaments (Programme de médicaments de l’Ontario, listes provinciales de m
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