Dental Provider Relations Representative – Contact Centre

Alberta Blue Cross; Alberta; On-site; CAD 45,000 - 60,000; Full time

Job summary

Alberta Blue Cross is seeking a temporary (24-month) Provider Relations Representative to join our Provider Relations Contact Centre in Alberta. The role handles telephone inquiries from health care providers about eligibility and claim submission requirements, delivering accurate information in line with program standards and policies.

You will verify claims, suggest workflow improvements, and document provider feedback for management review.

Qualifications

• Customer-focused role handling provider inquiries with discretion and accuracy.
• Strong listening and problem-solving skills to resolve eligibility and submission questions.
• Ability to learn and improve workflows in a busy contact centre environment.

Responsibilities

• Responds to telephone inquiries from providers on verification, eligibility, plan maximums and prior approvals.
• Verifies claims through online adjudication systems and documents outcomes.
• Records and forwards provider feedback to the Team Manager.
• Supports projects and analyses using Excel, Word and other software.
• Logs call details and assists with other duties as required.

Skills

Customer service

Communication

Problem solving

Attention to detail

Teamwork

Workflow improvement

Education

Medical/dental/pharmacy background

Tools

Microsoft Word

Microsoft Excel

Microsoft Office

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 are continuing to grow our team and are looking for a temporary (24-month) Provider Relations Representative to join our Provider Relations Contact Centre. The representative position responds to telephone inquiries from health care providers such as pharmacies, health care provider, or dental offices, regarding 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.

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 provider feedback to the appropriate Team Manager and/or Manager.
• Supports various projects and analyses using Excel, Word, 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:

• Computer proficiency, particularly with Microsoft Office (i.e. Word and Excel) is required.
• A medical, dental or pharmacy background and familiarity with dental procedures, health procedures or 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 center representative is an absolute must.

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 team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.

We offer the opportunity to work in an innovative, high-energy team-focused environment.

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