Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. We’re committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. We believe in what we do—and place trust in our employees to deliver our vision.

Working at Alberta Blue Cross® means having a career where you’ll be recognized for your contributions. We value diversity, encourage our team members to maintain a healthy work-life balance and provide opportunities for career growth.

OVERVIEW:

With the support of the Team Manager, and under the guidance of a team Lead, this position is responsible for day-to-day activities related to processing health and dental provider online direct billing applications, validating provider eligibility with the professional colleges and associations across Canada, and track provider agreements. This is a detailed position, requiring accuracy and efficiency, to ensure that work objectives and timelines are met and our reputation for excellent customer service is maintained.

WHAT YOU WILL DO:

• Process manual provider applications, including Health, Dental, and AADL providers with a high level of detail and accuracy.
• Enter and manage health claims to ensure timely payment for our providers and members.
• Represent Alberta Blue Cross when validating provider credentials with the provincial and national colleges and associations across Canada
• Perform quality assurance checks on provider eligibility and contacting providers when necessary
• Work closely with Alberta Health Services to process direct bill Ambulance claims and support their administration team with billing and payment questions
• Process Prior-Approvals for GNWT Vision, Travel, and Medical Supply and Equipment claims.
• Assist and educate providers with agreements, applications, compliance, and best practices.
• Research and analyze information to resolve complex inquiries or unique situations
• Monitor individual production to ensure acceptable quantity output and timelines are met
• Make suggestions to improve workflows, increase efficiency and be innovative

WHAT YOU WILL HAVE:

• Demonstrated commitment in delivering superior customer service, including establishing and maintaining effective working relationships with internal and external stakeholders
• Strong problem-solving abilities and attention to detail are critical, demonstrating the ability to use good judgment in evaluating and decision-making, and completing work with a high degree of accuracy
• Excellent organizational and time management skills with the ability to prioritize tasks, manage a heavy workload, and meet tight timelines
• Demonstrated willingness and ability to adapt to changing priorities and processes
• Demonstrated ability to work with minimal supervision, with a strong sense of accountability, in a work-from-home environment
• Demonstrated proficiency in Microsoft Word and Excel a must. Proficiency with Microsoft Access is a definite asset

This position will remain open until a suitable candidate is selected.

Alberta Blue Cross® is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.

We offer the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, apply online at careers.ab.bluecross.ca