Member Services - Claims Support Representative

Manitoba Blue Cross was born out of a desire to protect our fellow Manitobans during life’s most unexpected and sometimes challenging moments. This remains our driving force today, and fuels our ongoing commitment to providing superior health and wellness benefits that are delivered with compassion and excellence in service.

As an independent and not for profit organization for over 40 years, we provide health, dental, employee assistance, disability, travel and life coverage to over half a million Manitobans.

At Manitoba Blue Cross, our people are the key to our success!  Consider becoming part of our team of professionals committed to providing exceptional customer service.

Join us as we serve our neighbours to support and strengthen our community.




 

About Manitoba Blue Cross

We’re a Manitoba-based, not-for-profit, health benefits provider with a vision to be the trusted and essential health and wellness partner for all Manitobans. Every dollar made is reinvested in our infrastructure, our people, and our province with the goal of providing better care for our members, expanding our community impact and broadening our health care knowledge.

Why work for us?

Manitoba Blue Cross, is a Manitoba Top Employer. We are empowered to give back to the community, and we know that caring needs to start in our workplace with our own Manitoba Blue Cross team. We actively foster a culture that focuses on your satisfaction, development, diversity, and growth.

Culture of Caring

We strive to succeed at reaching our organizational goals, but we always make time to celebrate our successes. Having fun as a group and rewarding our employees for their accomplishments is an essential part of our workplace culture.

We want our workforce to reflect the diverse community we serve, and we're committed to creating a fair and respectful workplace. We offer a work environment that promotes a healthy work-life balance and support to advance your career that includes:

• Competitive starting salary.
• A comprehensive health benefit package.
• Hybrid work environment, flexible work schedules.
• Casual dress code to promote diversity and inclusivity.
• Personal and professional development.

Are you a driven, dedicated, and enthusiastic individual who wants to work in a friendly and rewarding environment?  If so, we are looking for someone like you! The following position is open to anyone residing in Winnipeg and surrounding areas with valid work authorization.

POSITION SUMMARY:

The Claims Support Representative opens and sorts Claims department mail, verifies claim forms for completeness, assists with other department correspondence, adjudicates and processes a wide variety of Health and Dental Benefit claims and supports the Claims processing team with administrative duties. The incumbent must work well independently as well as in a team setting.

DUTIES AND RESPONSIBILITIES

• Responsible for the organization of claims mail and correspondence received in the Claims department.
• Opens, screens claims for required information, date stamps, sorts and manages Claims department mail within production standards.
• Maintains claims received counts for production reporting.
• Returns claims to members and providers for claim forms or additional information.
• Assists with claims cheques, statements, pre-authorizations, and correspondence.
• Assists with memos.
• Assists with administrative duties for all areas of the departments.
• Assists with bonds and returned cheques.
• Adjudicates and processes standard and diverse Ambulance and Hospital, Extended Health, Prescription Drug, Vision and Dental claims in accordance with performance standards.
• Photocopies documents as required.
• Manages off-site processor returns.
• Processes UMSU address changes.
• Files documents as required.
• Assists with claims related storage.
• Performs other related duties as assigned

QUALIFICATIONS AND SKILLS

• Dedicated to the principles of exceptional service; committed to responding to, anticipating, and addressing customer needs, for both internal and external customers.
• Preference will be given to applicants who have completed some post secondary education. An equivalent combination of education and 1-2 years experience in an office environment may be considered.
• Excellent organizational skills with the ability to manage and prioritize several activities on an ongoing basis is a requirement.
• Good verbal and written communication skills including legible handwriting.
• Ability to work efficiently within prescribed performance standards.
• High attention to detail.
• Ability to work with minimum supervision.
• Excellent interpersonal skills with the ability to deal with all levels within the organization in a team environment.
• Completion of medical certificate courses an asset.
• Proficient computer skills including Word, Excel and e-mail software.
• Previous claims adjudication experience and/or experience in the health field are an asset.
• Knowledge of pharmacy, medical and dental products, and their terminology is an asset.
• Ability to learn and use MBC computer applications relevant to the Claims department.
• Capable of completing industry education programs entailing a self-directed study and the writing of graded examinations.  Specific programs include but are not limited to LOMA, CEBS and ICA.  Enrollment in, and completion of, such courses will be encouraged.

Ready to Apply? We are excited to meet you!

If you would like to join our team, you are invited to apply by submitting your resume and cover letter by clicking the "Apply" button below by January 24, 2025.

To learn more visit: https://www2.mb.bluecross.ca/about-us/careers

Thank you for your interest, we look forward to reviewing your application.

All qualified applicants will receive consideration for employment without regard to race, national or ethnic origin, colour, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, genetic characteristics, disability and conviction for an offence for which a pardon has been granted or in respect of which a record suspension has been ordered.

Only those being considered for the selection process will be contacted.