Claims Auditor conducting health audits and investigations at Alberta Blue Cross. Collaborating with providers for compliance and reporting findings in a hybrid work environment.
Responsibilities
Conduct health audits and investigations
Travel within Alberta for documentation collection
Complete claims analysis for compliance
Prepare working papers, letters, and reports
Issue reports on claims and monetary adjustments
Develop and maintain relationships with service providers and internal partners
Address client needs and recommend changes to processes and policies
Requirements
Post-secondary education in science, business, criminal justice, healthcare, or law
Investigative designation such as CFI or CFE preferable
3-5+ years experience in investigations
Exceptional communication skills
Experienced in investigation interviewing
Knowledge of databases and ability to analyze large amounts of data using Microsoft Excel
Ability to establish and maintain effective working relationships with both internal and external customers
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