Provider Relations Representative answering dental and healthcare provider inquiries for Alberta Blue Cross. Verifying claims, eligibility, approvals, and supporting process improvements.
Responsibilities
Respond to telephone inquiries from health care providers regarding subscriber verification, benefit eligibility, plan maximums, prior approval requirements, and claim inquiries
Verify claims through online adjudication systems
Suggest workflow and process improvements
Record and forward provider feedback to the appropriate Team Manager and/or Manager
Support projects and analyses using Excel, Word, and other computer software
Log call details
Assist with other duties as required
Requirements
Computer proficiency, particularly with Microsoft Office, including Word and Excel
Medical, dental, or pharmacy background is an asset
Familiarity with dental procedures, health procedures, or drug names is an asset
Proven customer service experience in person or over the phone is preferred
Strong listening and problem-solving skills
Pleasant telephone manner
Ability to thrive in a busy environment
Research and analysis skills to determine root causes of problems
Strong attention to detail and organizational skills
Desire for continuous learning
Advanced customer service skills
Criminal record check satisfactory to Alberta Blue Cross required as a condition of employment following a conditional offer
Benefits
Diversity and inclusion commitment
Healthy work-life balance
Career growth opportunities
Innovative, high-energy, team-focused work environment
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