Alberta Blue Cross
CaseManagementCoordinator(CMC)–Life&DisabilityServices
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Case Management Coordinator (CMC) – Life & Disability Services at Alberta Blue Cross. Skills: claim intake, claim maintenance, policy validation, benefit coverage validation. Ensure all intake forms are filed accurately. Maintain intake forms confidentially”
What You'll Achieve.
Ensure accurate claim intake; Ensure accurate claim maintenance; Validate policy and benefit coverage; Update claim systems throughout the claim lifecycle; Provide responsive support to plan members; Provide responsive support to beneficiaries; Provide responsive support to plan administrators; Accurate claim processing; Accurate adjudication
Industry & Context.
analytical skills
criminal record check satisfactory to Alberta Blue Cross
What They're Looking For.
Must Have
excellent knowledge and experience with Microsoft Word, excellent knowledge and experience with Microsoft Access, excellent knowledge and experience with Microsoft Excel, excellent knowledge and experience with Microsoft PowerPoint, Keen attention to detail, analytical skills, excellent verbal and written communication skills, organizational skills, able to work well under pressure, able to assess priorities in a confident manner, flexible, innovative, independent, work effectively with fellow employees and staff from other departments in a team focused atmosphere, excellent interpersonal skills
Nice to Have
Experience with database management
What You'll Do.
Ensure all intake forms are filed accurately
Maintain intake forms confidentially
Validate member information for claim processing
Validate census data for claim processing
Validate salary for claim processing
Validate eligibility for claim processing
Coordinate with Group Administration for member enrollment
Enroll members in their benefits
Create claim intakes in claim systems
Create claim intakes in reporting systems
Maintain compliance with processing standards
Set up required tasks for claim intake
Set up required tasks for claim maintenance
Respond to telephone inquiries from plan members
Respond to telephone inquiries from beneficiaries
Respond to telephone inquiries from plan administrators
Contact plan members for required information
Follow up with plan members for required information
Contact beneficiaries for required information
Follow up with beneficiaries for required information
Contact plan administrators for required information
Follow up with plan administrators for required information
Contact treating health care providers for required information
Follow up with treating health care providers for required information
Update claims throughout their lifecycle
Ensure timely upload of all incoming documentation
Ensure timely upload of all correspondence
Gather confidential documentation for plan members
Gather confidential documentation for plan administrators
Gather confidential documentation for physicians
Gather confidential documentation for treatment providers
Gather confidential documentation for lawyers
Gather confidential documentation for other stakeholders
Prepare confidential documentation for plan members
Prepare confidential documentation for plan administrators
Prepare confidential documentation for physicians
Prepare confidential documentation for treatment providers
Prepare confidential documentation for lawyers
Prepare confidential documentation for other stakeholders
Communicate with internal departments for information exchange
Exchange information on claims with internal departments
Exchange information on eligibility with internal departments
Exchange information on financial transactions with internal departments
Work collaboratively with Case Managers on CPPD recoveries
Work collaboratively with Adjudicators on CPPD recoveries
Work collaboratively with Payment Specialists on CPPD recoveries
Create initial packages for CPPD recoveries
Perform follow-ups for CPPD recoveries
Create letters for CPPD recoveries
How You'll Work.
Team & Collaboration
Coordinate communications with internal teams; Coordinate communications with external stakeholders; Work effectively with fellow employees; Work effectively with staff from other departments; Communicate with internal departments (Medical Underwriting, Group Underwriting, Sales, Group Administration, Payment team); Work collaboratively with Case Managers; Work collaboratively with Adjudicators; Work collaboratively with Payment Specialists
Communication Scope
excellent verbal and written communication skills
Full Job Description
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 team members to maintain a healthy work-life balance and provide opportunities for career growth. **OVERVIEW:** We are continuing to grow our team and are looking for a temporary (12-month) Case Management Coordinator (CMC). In this role, you will ensure accurate claim intake and maintenance, validating policy and benefit coverage, and updating claim systems throughout the claim lifecycle. You will coordinate communications with internal teams and external stakeholders, while providing responsive support to plan members, beneficiaries, and plan administrators. **WHAT YOU WILL DO:** * 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 adjudicati
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