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
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