Provider Relations Representative - Contact Centre

Working in a flexible work style arrangement, our clientis currently seeking an enthusiastic individual to join our Provider Relations Call Centre. The representative position responds to telephone inquiries from health care providers such as pharmacies, and medical offices, regarding drug benefit eligibility and claim submission requirements and outcomes for Alberta Blue Crossbenefit plan programs in accordance with the required standards, policies, rules and regulations. The ability to work nights, weekends, and statutory holidays on a rotation basis is required.

Requirements 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 pharmacy provider feedback to the appropriate Team Manager and/or Manager. Supp...

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