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    Provider Relations Representative - Mississauga, Canada - The Cigna Group

    The Cigna Group
    The Cigna Group Mississauga, Canada

    Found in: Talent CA C2 - 4 weeks ago

    Default job background
    OTHER
    Description
    The job profile for this position is Credentialing Lead Representative, which is a Band 2 Professional Career Track Role.

    Excited to grow your career?

    We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

    Our people make all the difference in our success.

    The role of Provider Relations is to accurately register healthcare providers and maintain a current database in order to support providers by delivering effective and timely communications to ensure seamless claims adjudication and claims payment.

    Express Scripts Canada seeks to hire a Provider Relations Representative to work from our Mississauga office. The successful incumbent will review network agreements from pharmacy, medical supplies & equipment, mental health care, vision care, and dental providers for accuracy and completeness and ensure that all providers' pertinent information is correctly entered into the Express Scripts Canada system.

    Please note, this is an on-site opportunity working out oour Mississauga Head Office.


    Key Responsibilities

    • Validates completed provider agreements and returns to providers for further review and modifications if information is missing
    • Ensures that all pharmacy, medical supplies & equipment and dental providers' required agreement information is entered into the Express Scripts Canada System in a timely manner
    • Ensures that all pharmacy, medical supplies & equipment, mental health care, visions care, and dental providers' modifications and terminations are updated in a timely manner
    • Handles provider, association and software vendor inquiries in a supportive and professional manner
    • Collaborates with teammates and assists in other team deliverables as required

    Qualifications

    • Post-Secondary school diploma
    • Bilingual an asset (French & English)
    • Excellent written, and verbal communication skills
    • Knowledge of healthcare/pharmacy, medical supplies & equipment or dental benefit administration and claims processing is an advantage
    • Strong customer service focus - understanding the Express Way Values
    • Computer literate, possessing intermediate skills in MS Office (Word, Excel, Outlook), and Adobe Reader and Writer
    • Strong interpersonal skills with ability to work independently with minimal supervision; and as a team player willing to take direction
    • Flexible to new situations and adaptable to change
    • A thorough understanding of quality assurance and delivery of service excellence
    • Excellent organizational skills, effective time management, and the ability to shift priorities working within established timelines
    • Demonstrates initiative (learn processes and procedures, various benefits) and displays self-motivation to grasp new concepts quickly
    • Ability to analyze, problem-solve and mediate difficult situations
    • Results-oriented paying attention to detail.

    NOTE: Internal candidates should apply before March 8, 2024.

    Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

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