Case Management Coordinator (Temp) – Claims & Collaboration

Alberta Blue Cross; United States; Remote; USD 42,000 - 68,000; Full time

Job summary

Alberta Blue Cross® is seeking a temporary (12-month) Case Management Coordinator in the United States to ensure accurate claim intake, validate policy and benefit coverage, and update claim systems across the lifecycle. You will coordinate communications with internal teams and external stakeholders to support plan members and plan administrators.

The role requires related post-secondary education and strong MS Office skills.

Qualifications

• Related post-secondary education.
• Must possess excellent knowledge and experience with Microsoft Word, Access, Excel, and PowerPoint.
• Keen attention to detail.
• Strong analytical skills.
• Excellent verbal and written communication skills.
• Must demonstrate strong organizational skills.
• Must be able to work well under pressure and be able to assess priorities in a confident manner.
• Must be flexible, innovative and independent.
• Must work effectively with fellow employees and staff from other departments in a team focused atmosphere.
• Experience with database management is an advantage.

Responsibilities

• Ensure all intake forms are filed accurately and maintained confidentially.
• Validate member information, census data, salary, and eligibility for accurate claim processing.
• Coordinates with Group Administration to enroll members in their benefits.
• Accurately create claim intakes in designated claim and reporting systems, maintaining compliance with processing standards.
• Set up required tasks to support claim intake and ongoing maintenance.
• Respond to telephone inquiries from plan members, beneficiaries and plan administrators.
• Contacts and follows up as required with plan members, beneficiaries, plan administrators and treating health care providers to obtain required information.
• Update claims throughout their lifecycle in claim systems, ensuring timely upload of all incoming documentation and correspondence from multiple submission channels (mail, email, fax, online) to support accurate adjudication.
• Gather and prepare confidential documentation for plan members, plan administrators, physicians, treatment providers, lawyers, and other stakeholders.
• Communicate with internal departments (Medical Underwriting, Group Underwriting, Sales, Group Administration, Payment team) to exchange information on claims, eligibility, and financial transactions.
• Work collaboratively with Case Managers, Adjudicators, and Payment Specialists on CPPD recoveries, including creating initial packages, follow-ups, and letters.

Skills

Analytical skills

Attention to detail

Verbal and written communication

Organizational skills

Ability to work under pressure

Team collaboration

Independent worker

Education

Related post-secondary education

Tools

Microsoft Word

Microsoft Access

Microsoft Excel

Microsoft PowerPoint

Job description

Alberta Blue Cross® is seeking a temporary (12-month) Case Management Coordinator in the United States to ensure accurate claim intake, validate policy and benefit coverage, and update claim systems across the lifecycle. You will coordinate communications with internal teams and external stakeholders to support plan members and plan administrators.

The role requires related post-secondary education and strong MS Office skills.