Analyst I – Clinical Drug Services

ABC Benefits Corporation; Edmonton; Hybrid; CAD 55,000 - 75,000; Full time

Job summary

Alberta Blue Cross is seeking a Special Authorization Analyst I in our Clinical Drug Services department to provide support and deliver timely special authorization service to customers in line with established guidelines. You will process requests, communicate with physicians and manage documentation efficiently.

The role requires health-administrative background, strong written/verbal communication, accuracy, and solid computer proficiency (MS Office, SharePoint/Teams).

Qualifications

• Post-secondary education in a health or related administrative program (e.g. Medical Office Administration certificate or diploma, Pharmacy Technician) or directly related experience.
• Excellent written and verbal communication skills, as well as strong organizational skills.
• Must be accurate and pay close attention to detail.
• Computer proficiency, particularly with Microsoft Office (Word, Excel; Access and SharePoint/Teams preferred).
• Must be customer oriented and a strong team player.
• Must possess strong analytical and decision making skills.
• Must have demonstrated ability to manage time effectively and work with minimum supervision in a team environment.
• Must have demonstrated ability to meet challenges of heavy workloads and frequent change.
• Knowledge of drug names is required.
• Familiarity with medical terminology would be an asset.

Responsibilities

• Research applicable patient coverage.
• Indexes documents into an electronic workflow and storage system.
• Assesses and renders decisions on select special authorization requests according to guidelines.
• Determines and interprets appropriate system entry and correspondence required.
• Enters information on Alberta Blue Cross systems to enable appropriate claims adjudication.
• Prepares and proofs correspondence related to Special Authorization.
• Handles telephone inquiries from internal and external customers.
• Assists with other duties and projects as required.

Skills

Analytical thinking

Communication skills

Attention to detail

Time management

Teamwork

Customer service

Medical terminology

Data entry

Microsoft Office

Education

Medical Office Admin

Pharmacy Technician

Health Admin Diploma

Tools

Microsoft Word

Microsoft Excel

Access

SharePoint/Teams

Job description

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 team members to maintain a healthy work-life balance and provide opportunities for career growth.

OVERVIEW

We currently have opportunities for a Special Authorization Analyst I in our Clinical Drug Services department. With the direction of the Team Manager, this position is responsible for providing support to the Clinical Drug Services department as well as delivering exceptional special authorization service to our customers within established standards for turn-around. Special Authorization is a process whereby physicians can request coverage for specific drugs for their patients.

WHAT YOU WILL DO

• Research applicable patient coverage.
• Indexes documents into an electronic workflow and storage system.
• Assesses and renders decisions on select special authorization requests according to established guidelines based on drug(s) requested and medical condition(s).
• Determines and interprets appropriate system entry and correspondence required.
• Enters information on Alberta Blue Cross computer systems regarding requests for special authorization in order to enable appropriate claims adjudication.
• Prepares and proofreads correspondence related to Special Authorization.
• Handles telephone inquiries from internal and external customers.
• Assists with other duties and projects as required.

WHAT YOU WILL HAVE

• Post secondary education in a health or related administrative program (i.e. Medical Office Administration certificate or diploma, Pharmacy Technician) or directly related experience.
• Excellent written and verbal communication skills, as well as strong organizational skills, are required.
• Must be accurate and pay close attention to detail.
• Computer proficiency, particularly with Microsoft Office (i.e. Word, Excel, and preferably Access and SharePoint/Teams) is required.
• Must be customer oriented and a strong team player.
• Must possess strong analytical and decision making skills.
• Must have a demonstrated ability to manage time effectively and work with minimum supervision in a team environment.
• Must have demonstrated ability to meet challenges of heavy workloads and frequent change.
• Knowledge of drug names is required.
• Familiarity with medical terminology would be an asset.

This position will remain open until a suitable candidate is 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 team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.

A criminal record check satisfactory to Alberta Blue Cross will be required as a condition of employment, following a conditional offer.

Alberta Blue Cross® is an Alberta based not-for-profit, dedicated to delivering exceptional customer experience and community leadership. We are 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.