Alberta Blue Cross (Alberta)
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 employees to maintain a healthy work-life balance and provide opportunities for career growth.
OVERVIEW:
We are continuing to grow our team and are looking for multiple temporary (12-month) Case Management Coordinators (CMC). Working under the direction and supervision of the Team Manager, Life & Disability Services, the CMC is responsible for claim intake and maintenance; including policy and benefit coverage validation, systems maintenance, as well as coordination and communication with relevant internal and external stakeholders, such as but not limited to Blue Cross Life, Group Division (all departments), Group Plan Administrators.
WHAT YOU WILL DO:
- Ensure forms are filed appropriately and kept confidential.
- Phone queue claim intake and status support.
- Authentication of claimants and external parties to ensure adherence to privacy guidelines.
- Creates claim intakes on adjudication system, and other report systems as required.
- Coordinates with Group Administration to enroll members in their benefits.
- Contacts and follows up as required with employers, plan members, beneficiaries, and physicians to obtain required information.
- Manage and upload all incoming correspondences, forms, and relevant documentation for claims adjudication or maintenance. This includes all channels of submission, including but not limited to mail, paper, email, fax, and online claim submission.
- Validates member information, census, salary, and eligibility information.
- Setup required tasking on claim for support of claim intake and maintenance,
- Prepares confidential correspondence for employers, members, physicians, treatment providers, lawyers, and other stakeholders.
- Updates claim, throughout its lifecycle in claims adjudication system, including but limited to Access and FINEOS.
- Gather relevant documentation for case file assembly as it relates to referrals, litigation, or subrogation requests.
- Work collaboratively with Case Manager’s, Adjudicators and Payment Specialists with CCPD recoveries; including but not limited to creation of initial package, follow up and letters.
- Communicate with internal departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, and Payment team to provide and exchange information regarding claims activities, eligibility, and financial transactions.
WHAT YOU WILL HAVE:
- Related post-secondary education.
- Must possess excellent knowledge and experience with Microsoft Word, Access, Excel, and PowerPoint.
- Keen attention to detail.
- Strong analytical skills.
- Must possess excellent verbal and written communication skills.
- Must demonstrate strong organizational skills.
- Must be able to work well under pressure and be able to assess priorities in a confident manner.
- Must be flexible, innovative and independent.
- Must work effectively with fellow employees and staff from other departments in a team focused atmosphere.
- Must demonstrate excellent interpersonal skills.
- Experience with database management is an advantage.
This position will remain open until suitable candidates are 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 employees by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.
We offer a competitive salary and benefits package and the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, please apply.
