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Provider Relations Work from Home Representative- Contact Centre

Remote
Alberta
Mid Level
full_time

About the role

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: Alberta Blue Cross is currently seeking an enthusiastic individual to join our Provider Relations Contact Centre. The representative position responds to telephone inquiries from health care providers such as pharmacies, health care provider, or dental offices, regarding benefit eligibility and claim submission requirements and outcomes for Alberta Blue Cross benefit plan programs in accordance with the required standards, policies, rules and regulations.

WHAT YOU WILL DO:

  • Responds to telephone inquiries from providers on subscriber verification, benefit eligibility, plan maximums, requirement of prior approvals and claim inquiries.
  • Verifies claims through online adjudication systems.
  • Makes suggestions for ways of improving workflows and processes.
  • Records and forwards provider feedback to the appropriate Team Manager and/or Manager.
  • Supports various projects and analyses using Excel, Word, and other computer software.
  • Logs details of calls.
  • Assists with other duties as required.

COMPETENCIES:

  • Handles complex inquiries independently, utilizing strong listening and problem-solving skills.
  • Works effectively with people, maintaining pleasant telephone manner.
  • Thrives in a busy environment.
  • Conducts research and analysis to determine the root of problems.
  • Strong attention to detail, organizational skills, and the desire for continuous learning is needed to meet the expectations of this role.
  • Assumes ownership of the position and accountability for information relayed to providers.
  • Demonstrates advanced customer service skills on a daily basis.

WHAT YOU WILL HAVE:

  • Computer proficiency, particularly with Microsoft Office (i.e. Word and Excel) is required.
  • A medical, dental or pharmacy background and familiarity with dental procedures, health procedures or drug names is an asset.
  • Preference will be given to individuals with proven customer service experience with either in person or over the phone contact. A true commitment to a career as a call centre representative is an absolute must.

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

About Alberta Blue Cross

Insurance
1001-5000

We believe that people, workplaces and communities deserve to be and live well—and we can help. As a benefits provider and wellness leader, we have the opportunity to play an important role in fostering the health and well-being of our customers across their lifetimes.

We provide benefits to more than 1.8 million Albertans through group, government and individual plans. Alberta-based, not-for-profit, wellness-driven, customer committed.

Living our values Our values represent who we are, what we stand for and the culture that guides us. In all we do, we keep our values at the forefront.

Integrity and trust

We are respectful, ethical, honest and inclusive in all that we do.

Wellness and flexibility

We promote and inspire a healthy culture of support, adaptability and compassion across our workplace and our communities.

Customer committed

We are accountable and committed to our customers and passionate in the delivery of an exceptional customer experience.

Empowering potential

We support learning and growth while fostering a diverse environment that cultivates collaboration and innovation.