Position Type:
PermanentIf you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.
As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.
Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.
The Claims Analyst - Alternate Funding Program is responsible for a wide variety of claim types under the Alternate Funding Program within Medicare. Each claim type has a varying degree of eligibility and policy requirements. The Claims Analyst will analyze, investigate, and pay medical claims which include the payment of locum, sessional, psychiatry and various other claims. Additionally, they are required to maintain current knowledge with respect to policy and procedure changes. The successful candidate will work with the leadership team and colleagues to help ensure exceptional customer service is provided to the Nova Scotia Department of Health and Wellness, and our provider and resident stakeholders.
Key Responsibilities:
Review, analyze and set up payment data based on contracts forwarded from the Department of Health & Wellness.
Maintain and reconcile contract payments to physicians using standard procedures.
Adjudicate and apply data entry functions for all alternate funding programs and billings from physicians with a strong emphasis on accuracy and efficiency.
Liaise with Physicians, support staff and various stakeholders in a professional manner with respect to system use, claims submissions, and payment reconciliations.
Review applications from the Boarding, Transportation and Ostomy Program as well as the Locum Program to determine eligibility
Support the update and development of business area procedures. This will include developing proper training material and support systems for business area
Perform quality assurance checks on claims adjudication to ensure payment accuracy and consistency among staff.
Support Escalations for claims adjudication in a calm manner with a sense of urgency. Liaise with internal and external partners to support resolution of concerns and to maintain effective working relationships.
Required Qualifications:
Education: Post-secondary education in Business Administration, Accounting, Finance or other related field, a combination of education and experience may be considered.
Work Experience: 3+ years of relevant experience would be an asset.
Other Qualifications: Able to adapt in a changing and fast paced environment with the ability to accept and implement changes; able to work independently. Possess a high attention to detail and a high level of accuracy; analytical in nature and have proven problem solving skills with an aptitude for mathematics.
Core Competencies:
Computer Skills: Experience working in a PC setting with multiple software applications (i.e., MS Office Suite: Excel, Word, Power Point ) including experience navigating between application and the internet. Strong keyboarding skills and the ability to enter data with speed and precision, accuracy and attention to detail.
Communication Skills: Excellent communication skills by way of verbal, written, and electronic medium. Listens to directions and instruction with the ability to accurately restate them to ensure full understanding.
Execution and Organization: High level of accuracy with attention to details while maintaining the ability to complete assigned tasks and meet deadlines. Ability to set and work through list of priorities in a timely manner.
Analytical Thinking: Develop the business knowledge and experience required to solve routine problems. Ask questions to determine the source of the problem. Discuss possible solutions and make suggestions.
Teamwork: Demonstrates a willingness to learn, while working collaboratively to achieve common goals by asking for feedback, sharing information and encouraging others to share information.
Language Skills: Bilingualism is considered an asset.
#CBM1
We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.
If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca.
We are committed to hiring military and Veteran spouses and encourage you to identify your connection with the MSEN when reaching out to us or applying to any of our open roles.
Have questions or want to learn more about us? We would love to hear from you!
kristen.drapeau@medavie.bluecross.ca
Whenever possible, reach out to a named contact rather than a general inbox - it helps ensure a quicker, more personalized response. If you hit a bounce-back, let us know at
Welcome to Medavie!
I would be happy to share and discuss our organization, current and future career opportunies.
Many of our roles are able to be remote (work from home) in Canada
- Kristen Drapeau, Senior Recruitment Consultant
-Krysta Duguay, Recruitment Consultant
Who we are
We’re a team of over 8,000 professionals serving clients from coast-to-coast with operations in most provinces. We provide health benefits to nearly 1 in 10 Canadians and manage emergency medical services for nearly 1 in 15 Canadians.
We’ve been a leading health services partner for individuals, employers and governments across Canada for 80 years and a premier all-in-one carrier that provides health, dental, travel, life and disability benefits to individuals and organizations.
We've been recognized as one of Canada's Most Admired Corporate Cultures, one of Canada's Top 100 Employers, and an Imagine Caring Company.
What we value
Our values are inherent to our culture and provide the framework for each interaction we have and transaction we make, while providing a clear set of expectations to empower employees to do the right thing for everyone we serve. We are:
Caring – We show compassion in everything we do
Accountable – We follow through on our commitments
Responsive – We have the courage to act and adapt
Innovative – We encourage and value new ideas
Community-minded – We achieve more together
More than simply a poster on the wall, our mission of improving the wellbeing of Canadians represents the purpose of our organization ― and we align that with our culture.
What we give back
As a not-for-profit organization, we don’t answer to shareholders. Instead, we invest our earnings in our business, our communities and, most importantly, our employees. We use some of these earnings to support:
Programs to support causes that are close to our employees' hearts, matching the volunteer hours and donations they contribute
An annual United Way workplace campaign led by employees in each of our locations
The Medavie Foundation, which invests in community initiatives and organizations that improve the wellbeing of Canadians, focuses on some of the most pressing mental and physical health challenges facing Canadians.
We want to meet you as you are
At Medavie Blue Cross, we foster a culture of openness, understanding and a sense of belonging where everyone can bring their true selves to work. Nearly 70% of our management roles are held by women and we’re committed to creating a diverse, equitable and inclusive workplace where everyone is valued for who they are and what they contribute. We will accommodate people with disabilities during the recruitment, selection and hiring processes.
What we offer
If you live our values and deliver results, you’ll experience meaningful, rewarding work in a purpose-centred, inclusive organization that provides:
Flexible work options: We want you to work where you work best. We offer work from home, from the office, or a hybrid of the two, while ensuring you feel connected to your team and to our purpose. Our flexibility goes beyond location. We also have flexible working hours and part-time options available.
Competitive compensation: We believe in rewarding our employees for the skills they bring to their jobs and the results they deliver. This includes competitive compensation that will reflect your experience and expertise and annual performance-based incentives, a 100% employer-matched defined contribution pension plan, an employee RRSP, one-on-one financial counselling, vacation and personal days to help you rest, refuel and balance your life.
Career Growth: Internal talent mobility and growth are an integral part of our success. Employees are empowered to own their career development and have rewarding experiences in a variety of work areas. Supportive leadership will encourage and coach you to maximize your potential so you can access multiple learning pathways to develop. Our leadership development program and other programs, such as mentoring, performance-based management and education assistance, are offered to provide employees with an environment of lifelong learning.
Outstanding benefits: Wellbeing is at the centre of everything we do and this starts with our employees. To help you take a proactive approach to your health, we provide: