Claims Assessor - Health Services- Work from Home


Location Name
Alberta Blue Cross - Edmonton
Edmonton, Alberta, CA
Date Posted Jul 23, 2019
Profession Administrative
Career Level(s) Entry Level
Job Type(s) Permanent, Full Time
Education Level(s) Not Specified
Job ID job-9586

Position Summary


The overall responsibility in this position is to ensure that the claims we receive are appropriately managed. This involves accurate and efficient entry and adjudication of health claims.


  • Enter and manage health claims to ensure timely payment for our providers and members.
  • Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance is required.
  • Respond to inquiries from internal customers regarding all aspects of health benefits and claims assessment.
  • Follow through to ensure effective and efficient resolution of all inquiries.
  • Contact providers and members to obtain necessary information to assess claims.
  • Adjudicate claims in accordance with unit procedures and Health Services standards with a high degree of accuracy and efficiency.
  • Monitor individual production to ensure that claim turnaround and volume expectations are met.
  • Make suggestions to improve workflows and processes.


  • Demonstrated excellence in verbal communication and listening skills in the delivery of superior service to customers in previous roles.
  • Demonstrated excellence in accuracy and multi-tasking under tight time frames and heavy workload.
  • Demonstrated ability to work with minimal supervision and within a team environment.
  • Demonstrated problem-solving and decision-making capabilities as well as strong organizational skills.
  • Strong attention to detail and a desire for continuous learning.
  • Proficiency with Microsoft Office Suite is required.
  • Willingness to work scheduled shifts within business hours of 8:00 a.m. and 5:00 p.m.
  • Willingness to work extra hours and overtime hours as needed.

Alberta Blue Cross offers a competitive salary and benefits package and the opportunity to work in a challenging team-oriented environment.  This position will be open until suitable candidates are selected.  If you have the qualifications we are looking for, please submit your resume and salary expectations to

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