Hybrid Claims Auditor – Health and Dental Providers

Posted last month

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About the role

  • Claims Auditor conducting audits of health and dental providers for compliance. Working at Alberta Blue Cross, offering services to over 1.8 million members.

Responsibilities

  • Conduct dental and/or health audits/investigations and ensure compliance
  • Field work to collect documentation
  • Complete claims analysis to ensure compliance with provider agreements
  • Prepare working papers, letters, and reports
  • Issue reports on claims and/or monetary adjustments
  • Develop and maintain good relationships with service providers and internal partners
  • Address internal and external clients’ needs

Requirements

  • Post-secondary education in science, business, criminal justice, health care, and/or law
  • Relevant experience in law enforcement can be considered in lieu
  • Investigative designation such as CFI or CFE is preferable
  • Exceptional written and verbal communication skills
  • Experienced in investigation interviewing
  • Commitment to quality customer service
  • Ability to establish and maintain effective relationships with customers
  • Knowledge of databases and ability to analyze large amounts of data using Microsoft Excel
  • Experience in the dental and health care benefits industry is preferable

Benefits

  • Health coverage for over 1.8 million members
  • Opportunities for career growth
  • Healthy work-life balance
  • Inclusive employer supportive of diverse backgrounds and experiences

Job title

Claims Auditor – Health and Dental Providers

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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