Provider Service Coordinator - Health Services

Details

Location Name
Alberta Blue Cross - Edmonton
Edmonton, Alberta, CA
Date Posted May 29, 2019
Profession Administrative
Career Level(s) Entry Level
Job Type(s) Permanent, Full Time
Education Level(s) Not Specified
Job ID job-9576

Position Summary

FUNCTION:

The overall responsibility in this position is to provide exceptional service to internal and external customers using their exemplary interpersonal skills, and strong problem-solving abilities. The Provider Service team identifies patterns, common errors and sytem issues of providers, to aid the department in reducing risk and improving efficiency.This position reports to the Team Manager of Provider Services.

DUTIES AND RESPONSIBILITIES:

  • Respond to telephone inquiries from members, external service providers and internal customers regarding all aspects of health benefits and claims assessment.
  • Serve as an expert resource for the health department and Provider eligibility related inquiries from other departments.
  • Create, verify, and maintain provider files in BlueExpress within a variety of systems.
  • Reports, in documented form to the Team Manager and Team Lead, any discrepancies or suspect claims that are not in line with contractual agreement.
  • Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance is required.
  • Make suggestions to improve workflows and processes.

SKILLS AND KNOWLEDGE:

  • Knowledge of health plan designs is preferred. 
  • Previous experience on a phone queue would be an asset.
  • Requires excellent decision making skills.  Ability to work under pressure.
  • Demonstrated initiative, results orientation and dedication to continuous improvement.
  • Strength in the areas of flexibility and innovation.
  • Computer literacy and experience with a variety of software programs, such as Microsoft Office.
  • Demonstrated excellence in verbal communication and listening skills.
  • Demonstrated ability to work with minimal supervision and within a team environment.
  • Demonstrated ability to successfully support clients and key stakeholders over the phone.
  • 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 www.ab.bluecross.ca.


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