To protect the security of personal information, your Internet browser will need to be upgraded to access this website. Please ensure you use the latest version of:

Internet Explorer

Microsoft Edge

Mozilla Firefox

Google Chrome

Safari

Analyst – Pharmacy Provider Agreement & Administration

Administrative

|

Edmonton

|

Permanent Full Time

Date posted

April 20, 2022

Closing date

June 3, 2022

1 Permanent – Full Time - Work from Home

2 Temporary - Full Time - Work from Home

Let’s impact lives for the better!

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:

With the support of the Team Manager, and under the guidance of a team Senior, this position is responsible for day-to-day activities related to processing manual pharmacy claims, managing complex pharmacy drug claim inquires, and adjusting direct bill drug claims.  This is a detailed position, requiring accuracy and efficiency, to ensure that work objectives and timelines are met and our reputation for excellent customer service is maintained. 

WHAT YOU WILL DO:

  • Process manual pharmacy claims, including high-cost drug claims, ensuring claims are adjudicated accurately in accordance with drug benefit plan coverage, and in a timely manner
  • Perform quality assurance checks on claim adjudication results, and complete claim adjustments when necessary
  • Assist and educate pharmacy providers with claims submissions and reversals, including collection of monies from pharmacy providers
  • Research and analyze information to resolve complex inquiries or unique situations
  • Create patient profiles
    Track and complete reporting on work initiatives
  • Monitor individual production to ensure acceptable quantity output and timelines are met
  • Make suggestions to improve workflows, increase efficiency and be innovative
  • Be willing to occasionally work flexible hours

WHAT YOU WILL HAVE:

  • Demonstrated commitment in delivering superior customer service, including establishing and maintaining effective working relationships with internal and external stakeholders
  • Strong problem-solving abilities and attention to detail are critical, demonstrating the ability to use good judgment in evaluating and decision-making, and completing work with a high degree of accuracy
  • Excellent organizational and time management skills with the ability to prioritize tasks, manage a heavy workload, and meet tight timelines
  • Demonstrated willingness and ability to adapt to changing priorities and processes
  • Demonstrated ability to work with minimal supervision, with a strong sense of accountability, in a work-from-home environment
  • Demonstrated proficiency in Microsoft Word and Excel a must.  Proficiency with Microsoft Access is a definite asset
  • Knowledge of the pharmacy industry, including drug plan design and claim adjudication standards, is an asset

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. This position will remain open until a suitable candidate is selected.  If you have the qualifications we are looking for, apply online at
careers.ab.bluecross.ca

COVID-19 Vaccination Notice: Alberta Blue Cross has a COVID-19 Vaccination Policy that applies to all of its employees.  As a condition of employment, successful job applicants will be asked to confirm their COVID-19 vaccination status and if required to go to the office may be required to provide proof of a valid negative COVID-19 test or a valid exemption pursuant to applicable human rights law if not fully vaccinated.

Join our team

Date posted

April 20, 2022

Apply

About us

Let’s impact lives for the better!

Alberta Blue Cross® is Alberta based, not-for-profit and 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 the wellness of all Albertans. 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 training and career growth.