- Register, review, validate, and adjudicate claims on a daily basis as per processes documented in the APM.
- Monitor and handle pended claims to ensure they are settled according to the Service Level Standards.
- Consistently meet the minimum accuracy standards of 98%.
- Consistently meet the productivity standards for assigned quotas within the established Service Delivery Standards.
- Participate in frequent quality and productivity touchpoints.
- Engage in bi-weekly claim department and monthly benefit process meetings.
- Handle claim adjustments that are provided from various departments.
- Participate in annual Privacy and Compliance Training.
- 1+ years' experience with data entry with proven records of excellent accuracy
- Experience working in an operational setting an asset
- Experience in the group insurance industry an asset
- Excellent verbal and written communication skills.
- Strong focus on customer service is required
- Quick learner and ability to make decisions with minimal supervision
- Strong analytical skills and ability to work or interpret data independently
- Self-motivation, determination and ability to work effectively in a fast paced, rapidly changing environment
- Excellent time management, organizational and interpersonal skills
- Working knowledge of Microsoft Office Suite of Tools (Word, Excel, Outlook)
-
Pharmacy Assistant- Express Scripts Canada
3 weeks ago
The Cigna Group Mississauga, Canada**This is a 1 year contract** · The Pharmacy Assistant is responsible for packaging and shipping of pharmaceuticals (both refrigerated and non-refrigerated) and medical supplies. The clerk will use various warehouse equipment and computer systems. Training will be provided. · **E ...
-
The Cigna Group Mississauga, CanadaThe Express Scripts Canada Pharmacy, with regional services across the country is transforming the Canadian prescription drug landscape and the way patients make decisions about their medications. · Our Mississauga Pharmacy Location is seeking a Pharmacy Assistant that provides m ...
-
Bilingual Dental Auditor-express Scripts Canada
3 weeks ago
The Cigna Group Mississauga, CanadaThe role of the Fraud, Waste and Abuse team is to enhance the Express Scripts Canada (ESC) value proposition for customers to ensure the integrity of health claims while maintaining a network of providers through diligent review and education. The Dental Benefit Auditor is respon ...
-
Bilingual Dental Auditor-Express Scripts Canada
2 weeks ago
The Cigna Group Mississauga, Canada Full timeThe role of the Fraud, Waste and Abuse team is to enhance the Express Scripts Canada (ESC) value proposition for customers to ensure the integrity of health claims while maintaining a network of providers through diligent review and education. The Dental Benefit Auditor is respon ...
-
Claims Processor- Express Scripts Canada
2 weeks ago
The Cigna Group Toronto, CanadaExpress Scripts Canada administers claim adjudication services on behalf of Indigenous Services Canada. This role entails adjudicating Non-Insured Health Benefit Claims for Indigenous peoples in Canada. · The role of a Senior Claims Processor is to process health benefit claims. ...
-
The Cigna Group Mississauga, Canada OTHERJob Description · The Express Scripts Canada Pharmacy, with regional services across the country is transforming the Canadian prescription drug landscape and the way patients make decisions about their medications. Our Mississauga Pharmacy Location is seeking a Pharmacy Assistant ...
-
Claims Processor- Express Scripts Canada
2 weeks ago
The Cigna Group Toronto, Canada OTHERThis is a 3 Month Contract · Description: · Express Scripts Canada administers on behalf of Indigenous Services Canada Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada. · The role of a Claims Processor is ...
-
Pharmacy Assistant Communication-express Scripts
3 weeks ago
The Cigna Group Mississauga, CanadaThe Express Scripts Canada Pharmacy, with regional services across the country is transforming the Canadian prescription drug landscape and the way patients make decisions about their medications. · Our Mississauga Pharmacy Location is seeking a Pharmacy Assistant that provides m ...
-
The Cigna Group Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
2 weeks ago
The Cigna Group Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
3 weeks ago
Cigna Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
3 weeks ago
The Cigna Group Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
2 weeks ago
The Cigna Group Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
2 weeks ago
The Cigna Group Mississauga, CanadaThe 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 ...
-
Service Desk Analyst
3 weeks ago
The Cigna Group Mississauga, Canada**ESSENTIAL FUCTIONS**: · - Maintain a Product Care Centre processes that meets ITIL standards · - Impart business knowledge to assist and support Express Scripts Canada's internal customers on day-to-day system issues · - Maintain incident management ticket queues and adhere to ...
-
Specialty Support Administrator- Express Scripts
3 weeks ago
The Cigna Group Mississauga, Canada**This is a 12 Months contract** · Express Scripts Canada is looking for Specialty Support Administrators to work within our Advocate Services Department. This department helps patients navigate processes associated with taking specialty medication, including cost reimbursement a ...
-
Marketing and Communications Specialist- Express
3 weeks ago
The Cigna Group Mississauga, Canada**Requirements**: · **Qualifications**: · Degree in Marketing, Business, Communications, in a related field, or equivalent experience. · Proven work experience as a Marketing & Communications Specialist or similar role. · A Problem-solver - Leading with a creative mindset and the ...
-
The Cigna Group Mississauga, CanadaThe 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 ...
-
Provider Relations Representative
2 weeks ago
The Cigna Group Mississauga, Canada Part timeThe 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 ...
-
Provider Relations Representative
3 weeks ago
The Cigna Group Mississauga, CanadaThe 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 ...
Claims Processor- Express Scripts Canada - Mississauga, Canada - The Cigna Group
Description
This is a 3 Month Contract
Description:
Express Scripts Canada administers on behalf of Indigenous Services Canada Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada.
The role of a Claims Processor is to register, review, validate, and adjudicate claims on a daily basis ensuring data integrity in the system. Claims Processors are responsible for processing Pay Provider, Pay Client and Client Reimbursement claims for all regions and are responsible for ensuring all pended claims are processed within the standard turn-around time.
This role is instrumental in meeting our Claims Processing Service Levels which contributes to customer satisfaction and minimizes risk of financial penalties.
Key Responsibilities:
Qualifications
Express Scripts Canada is a Cigna company
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.
About Express Scripts Canada
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active PharmacyTM services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.
It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.
We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.