Provider Relations Work from Home Representative- Contact Centre - Insurance Jobs

Job Description

About the Provider Relations Work from Home Representative - Insurance Jobs

OVERVIEW:

Alberta Blue Cross® is currently seeking an enthusiastic individual for a temporary position to join our Provider Relations Call Centre working in a flexible work style arrangement. 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 Cross benefit 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.

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.
• Supports various projects and analyses using Excel, Word, Access, 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:
 

• A medical or pharmacy background and familiarity with 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.
• Computer proficiency, particularly with Microsoft Office (i.e. Word and Excel, and preferably Access) is required.