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Claims Analyst - Alternate Funding Program

Medavie

Nouvelle-Écosse, Nouvelle-Écosse

Claims Analyst - Alternate Funding Program

Medavie

Nouvelle-Écosse, Nouvelle-Écosse
 
Salary: Information not available
 
Télétravail
Nouvelle-Écosse
Temps plein
Publié il y a 5 jour(s)
R-267886

Type de poste:

Permanent

À la recherche d’une carrière épanouissante qui changera réellement votre vie et celle des autres? Vous êtes au bon endroit.

À titre de partenaire national en solutions de santé, nous plaçons les gens au cœur de tout ce que nous faisons – en commençant par notre équipe de plus de 8 000 employés et employées qui mettent à profit leurs expériences personnelles et professionnelles diversifiées dans le cadre de leur travail à Medavie. Par l’entremise de la collaboration et de l’innovation, notre équipe crée des solutions d’assurance, de soins primaires et de services médicaux d’urgence à l’avant-garde de l’industrie qui viennent en aide à des millions de Canadiens et Canadiennes chaque année.

Notre mission est d’améliorer le bien-être de la population canadienne afin que chaque personne puisse profiter pleinement de la vie, et cela se reflète dans notre culture d’entreprise primée. Nous célébrons l’individualité des membres de notre personnel et accordons de la valeur à la diversité de leurs points de vue et de leurs compétences. C’est pourquoi en plus de vous offrir une rémunération concurrentielle et une gamme complète d’avantages sociaux, nous vous donnons accès à des possibilités de croissance professionnelle et personnelle, à des modalités de travail flexibles, à des expériences enrichissantes, ainsi qu’à un leadership bienveillant. À Medavie, chaque personne peut donner le meilleur d’elle-même, se sentir à sa place et atteindre son plein potentiel. Joignez-vous à nous en postulant un poste dès aujourd’hui.

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. Knowledge and training in Medical Terminology.

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: English required, French is considered an asset.

What’s in it for you?  

What makes us a different kind of employer? Our award-winning culture, a team who really cares, unmatched training and support are all dedicated to ensuring you are set up for success.

What we offer:  

  • Permanent full-time position with opportunity to grow in a well-established organization.

  • Flexible work arrangements and emphasis on work-life balance.

  • Remote and hybrid work options.

  • Comprehensive health, vision and dental plan that is 100% employer paid effective on your first day.

  • 100% employer-matched Defined Contribution Pension Plan

  • Annual Incentive Bonus which recognizes your contribution to our success. 

  • In addition to paid vacation, we offer a gifted week of vacation in your first year and an optional Vacation Purchase Program. 

  • An organization where we encourage personal learning and growth with opportunities for career development 

#CBM1

This posting is for an existing vacancy within our organization / Ce poste est actuellement vacant au sein de notre organisation.

Échelle Salariale:

46,292 - 52,078 CAD

L’échelle salariale de base proposée peut dépendre du dossier de candidature de la personne retenue ou d’autres facteurs professionnels comme les connaissances, les compétences, la qualification, l’expérience et la formation. En plus de recevoir le salaire de base, les employés et employées admissibles de Medavie peuvent participer à divers programmes de bonification fondés sur le rendement. Le versement des paiements associés à ces programmes est discrétionnaire et dépend des résultats individuels et de ceux de l’entreprise.  

Nous croyons que les membres de notre personnel doivent représenter les collectivités que nous servons et nous encourageons les personnes de tous les horizons à poser leur candidature. Pour vous offrir la meilleure expérience qui soit, nous vous proposons des mesures d’adaptation pour chacune des étapes du processus de recrutement. Il vous suffit d’en faire la demande à l’équipe de recrutement. Nous nous engageons à veiller à ce que le recrutement, la fidélisation et le perfectionnement des employés et employées, de même que leur rémunération, demeurent équitables, tiennent compte des besoins en matière d’accessibilité et respectent l’ensemble des droits de la personne et des lois sur la protection de la vie privée qui s’appliquent. Nous remercions toutes les personnes qui ont manifesté de l’intérêt pour ce poste. Veuillez noter que nous communiquerons seulement avec les personnes retenues pour une entrevue.

Des outils fondés sur l’intelligence artificielle sont utilisés dans le cadre de notre processus d’embauche afin d’appuyer l’évaluation des candidatures.

Si vous rencontrez des problèmes techniques au cours de votre procédure d'application, veuillez envoyer un courriel à : Medavie.Recruitment@medavie.ca.

About Medavie

 

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:

  • Comprehensive benefits to support you and your family, including fully paid premiums for medical, dental and vision insurance
  • Extensive mental health support (including virtual care options and an employee family assistance program)
  • Health spending and personal wellness accounts that allow you to claim everything from art gallery memberships to Wi-Fi, fitness membership discounts, and more
  • A digital rewards and recognition program to support and empower you on your wellbeing journey
  • Family-friendly and inclusive benefits like maternity and paternity leave top-up, gender affirmation support and fertility coverage to support your growing family