Health Claims Assessor

Permanent

As a national health solutions partner we put people first in everything we do and that begins with our team of 8000 professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together our employees are creating industry-leading solutions in insurance primary care and emergency medical services that impact millions of lives in Canada each year.

We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth flexible work options meaningful experiences and supportive leadership. The Claims Analyst - Alternate Funding Program is responsible for a wide variety of claim types under the Alternate Funding Program within Medicare. Each claim type has a varying degree of eligibility and policy requirements. The Claims Analyst will analyze investigate and pay medical claims which include the payment of locum sessional psychiatry and various other claims. Additionally they are required to maintain current knowledge with respect to policy and procedure changes. The successful candidate will work with the leadership team and colleagues to help ensure exceptional customer service is provided to the Nova Scotia Department of Health and Wellness and our provider and resident stakeholders.

Review analyze and set up payment data based on contracts forwarded from the Department of Health & Wellness.
Maintain and reconcile contract payments to physicians using standard procedures.
Adjudicate and apply data entry functions for all alternate funding programs and billings from physicians with a strong emphasis on accuracy and efficiency.
Liaise with Physicians support staff and various stakeholders in a professional manner with respect to system use claims submissions and payment reconciliations.
Review applications from the Boarding Transportation and Ostomy Program as well as the Locum Program to determine eligibility
This will include developing proper training material and support systems for business area
Perform quality assurance checks on claims adjudication to ensure payment accuracy and consistency among staff.
Support Escalations for claims adjudication in a calm manner with a sense of urgency. Education: Post-secondary education in Business Administration Accounting Finance or other related field a combination of education and experience may be considered.

Work Experience: 3 years of relevant experience would be an asset.

Computer Skills: Experience working in a PC setting with multiple software applications (i.e. MS Office Suite: Excel Word Power Point ) including experience navigating between application and the internet. Strong keyboarding skills and the ability to enter data with speed and precision accuracy and attention to detail.

Language Skills: Bilingualism is considered an asset.

#We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible we will support you with accommodations or adjustments at any stage of the recruitment process. If you experience any technical issues throughout the application process please email: .