Claims Coordinator – Provider Services

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

OVERVIEW:

Alberta Blue Cross® is currently seeking a temporary (18-month) Claims Coordinator to join our Provider Services team. The overall responsibility in this position is to ensure that the claims we receive are appropriately managed. This involves accurate and efficient entry and adjudication of dental claims and treatment plans. An additional critical component of this role is to handle the adjudication of electronically submitted dental claims.

WHAT YOU WILL DO:

• Enter and manage dental claims and treatment plans to ensure timely payment for our providers and members.
• Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance is required.
• Contact providers to obtain necessary information to assess claims.
• Adjudicate claims in accordance with Dental Services polices and standards with a high degree of accuracy and efficiency.
• Monitor individual production to ensure that claim turnaround expectations are met.
• Make suggestions to improve workflows and processes.

WHAT YOU WILL HAVE:

• Knowledge of dental terminology and nomenclature is a definite asset.
• Demonstrated excellence in accuracy and multi-tasking under tight time frames and heavy workload.
• Demonstrated ability to work with minimal supervision and within a team environment.
• Demonstrated problem-solving and decision-making capabilities as well as strong organizational skills.
• Strong attention to detail and a desire for continuous learning.
• Proficiency with Microsoft Office Suite is required.