Pharmacy Provider Relations Representative – Contact Centre

Alberta Blue Cross
Full time
Accounting and Finance
Canada
Hiring from: Canada
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:

Alberta Blue Cross is currently seeking Pharmacy Provider Relations Representatives for a temporary (12-month) position to join our Provider Relations team working in a flexible work style arrangement. The representative will respond 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.


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.

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

Wealthsimple
Full time
Your career is an investment that grows over time! Wealthsimple is on a mission to help everyone achieve financial freedom by reimagining what it means to manage your money. Using smart technology, we take financial services that are often confusing,...
Accounting and Finance
Canada
Hiring from: Canada
Company Name: PBS Systems Job Location: Montreal, Quebec Job Type: Full-time, Permanent, Remote No. of Openings: 01 Internal Job Title: DTO – Bilingual Accounting Trainer Reports To: Team Lead, DTO Accounting Job Requirement(s): Up to 2 weeks of travel within...
Accounting and Finance
Canada
Hiring from: Canada
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest. As a member of the Process Excellence team, you will be a...
Accounting and Finance
Canada
Hiring from: Canada