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Join to apply for the Pharmacy Analyst- Provider Services role at Alberta Blue Cross Join to apply for the Pharmacy Analyst- Provider Services role at Alberta Blue Cross Alberta Blue Cross is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. Were 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 doand place trust in our employees to deliver our vision. Working at Alberta Blue Cross means having a career where youll 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: Alberta Blue Cross is currently seeking an enthusiastic individual for a temporary position to join our Pharmacy Provider Agreement & Administration team working in a flexible work style arrangement. With the support of the Team Manager, and under the guidance of a Team Lead, this position is responsible for day-to-day activities related to processing manual pharmacy claims, managing complex pharmacy drug claim inquires, and adjusting direct bill drug claims. This is a detailed position, requiring accuracy and efficiency, to ensure that work objectives and timelines are met, and our reputation for excellent customer service is maintained. WHAT YOU WILL DO: Process manual pharmacy claims, including high-cost drug claims, ensuring claims are adjudicated accurately in accordance with drug benefit plan coverage, and in a timely manner. Perform quality assurance checks on claim adjudication results, and complete claim adjustments when necessary. Assist and educate pharmacy providers with claims submissions and reversals, including collection of monies from pharmacy providers. Perform system testing. Research and analyze information to resolve complex inquiries or unique situations. Track and complete reporting on work initiatives. Monitor individual production to ensure acceptable quantity of output and timelines are met. Make suggestions to improve workflows, increase efficiency, and be innovative. Be willing to occasionally work flexible hours. WHAT YOU WILL HAVE: Demonstrated commitment in delivering superior customer service, including establishing and maintaining effective working relationships with internal and external stakeholders. Strong problem-solving abilities and attention to detail are critical, demonstrating the ability to use good judgment in evaluating and decision-making, and completing work with a high degree of accuracy. Excellent organizational and time management skills with the ability to prioritize tasks, manage a heavy workload, and meet tight timelines. Demonstrated willingness and ability to adapt to changing priorities and processes. Demonstrated ability to work with minimal supervision, with a strong sense of accountability, in a flexible work style arrangement. Computer proficiency with Microsoft Word, Excel, and Outlook is essential. Exposure to Access would be beneficial. Knowledge of the pharmacy industry, including drug plan design and claim adjudication standards, is an asset. This position will remain open until a suitable candidate is selected. Alberta Blue Cross is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences. We offer the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, apply online at careers.ab.bluecross.ca Seniority level Seniority level Not Applicable Employment type Employment type Full-time Job function Job function Health Care Provider Industries Insurance Referrals increase your chances of interviewing at Alberta Blue Cross by 2x Get notified about new Pharmacy Analyst jobs in Alberta, Canada. Work from Home | Online Data Analyst - English Speaker Senior Analyst, Investment Performance & Analytics Senior Tade Settlements Analyst Public Market Operations Fort McMurray, Alberta, Canada 3 weeks ago Analyst II, Credit Risk- Portfolio Monitoring and Direct to Consumer Analyst II, Credit Risk- Portfolio Monitoring and Direct to Consumer Global Senior Financial Operations Analyst Analyst II, Credit Risk - Wallets and Partnerships Analyst II, Credit Risk - Wallets and Partnerships Data Partner GenAI - Computer Science - North America Work from Home | Online Data Analyst - French Speaker Freelance Online Data Analyst - Canada (French Speaker) Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr