Job Title: Bilingual Dental Consultant Location: Mississauga/Montreal Employment Type: Part Time/Contract Reason for Vacancy: Replacement Work Arrangement: Hybrid Department Name: Fraud, Waste and Abuse Pay Type: Hourly Pay Range: $100.00/hour-$110.00/hour Please note that this is a general posting range and offer range will be varied based on relevant experience, qualifications, skills required and location for this role. About Us Express Scripts Canada (ESC) is the leader in health benefits management. Serving over 12 million members, we help insurance carriers, third party administrators, and the public sector optimize the value of health benefits by linking the talent and professional expertise of our people with leading edge information management systems and technology. Express Scripts Canada is a wholly owned subsidiary of Express Scripts, one of the largest pharmacy benefit management (PBM) companies in North America, part of The Cigna Group (NYSE: CI), a global health company. Together, we deliver innovative, cost-effective solutions that improve access, affordability, and health outcomes for Canadians Job Summary: Express Scripts Canada has an exciting opportunity for a Dentist who is looking to expand their career to use their analytical and investigative skills along with their practice and knowledge of benefit coverage. This part-time role in the Business Integrity team enhances 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. NOTE: This position includes travelling (25%) across Canada. This is a 12 months contract with a strong possibility of extension. Key Responsibilities Review provider claims reports to identify abnormal or inconsistent claims submissions Perform on-site audits at the provider''s location in Canada Review & summarize findings from provider chart/clinical notes, radiographs, lab bills, etc. Review audit reports for quality, accuracy, and proper audit application Provide clinical opinion to support audit specialists Participate as required in peer reviews with external clients Consult with internal and external stakeholders regarding audit activities Continuously review and provide recommendations regarding claims verification risk criteria What We''re Looking For: Minimum of 5 years of recent and demonstrated experience within a dental office environment Current registration with a provincial college Ability to manage confidential information Strong focus on quality and accuracy Detail-oriented with proven high-level oral and written communication skills Demonstrates and applies integrity in all aspects of work Excellent time management and organizational skills Knowledge of Microsoft Office software (Word, Excel and PowerPoint) Bilingualism (French & English) is required. Why Join Us? Competitive compensation, benefits and pension plan Career development and advancement opportunities A culture that celebrates innovation and collaboration Flexible work options and wellness programs Pre-Employment Requirements All offers of employment are conditional upon the successful completion of reference checks and background verification in accordance with company policy . Within ESC, for certain positions, obtaining and maintaining a federal government security clearance is a condition of employment. Candidates applying for such roles must meet all eligibility criteria for the applicable clearance level and consent to the security screening process as mandated by federal regulations. Failure to obtain or maintain the required clearance will result in withdrawal of the offer or termination of employment. Our hiring process includes AI-powered tools to conduct video interviews, take notes and score candidates; however, all scores will be reviewed by hiring managers and our Talent team before making a decision. ________________________________________________________ Poste: Dentiste-conseil bilingue Lieu de travail: Mississauga/Montreal Type d''emploi: Temps partiel/ Contractuel Raison de l''embauche: Remplacement Environnement de travail: Tltravail Nom du service: Audits sur la fraude, le gaspillage et l''abus Type de rmunration: Horaire chelle salariale: 100,00$ 110,00$. Veuillez noter qu''il s''agit d''une chelle salariale gnrale et que l''offre variera en fonction de l''exprience, des qualifications, des comptences requises et du lieu de travail pour ce poste. propos de nous ExpressScriptsCanada est le chef de file en matire de gestion de rgimes de soins de sant. Nous offrons des services plus de 12millions de participants et nous aidons les assureurs, les tiers administrateurs et le secteur public optimiser la valeur des rgimes de soins de sant en utilisant notre expertise professionnelle, nos systmes de pointe en gestion de l''information ainsi que notre technologie. ExpressScriptsCanada est une filiale en proprit exclusive d''ExpressScripts, l''un des plus importants gestionnaires de rgime d''assurance mdicaments en Amrique du Nord qui fait partie du CignaGroup (NYSE: CI), une socit mondiale de soins de sant. Ensemble, nous offrons des solutions novatrices et efficientes qui amliorent l''accs, l''abordabilit et les rsultats sur le plan de la sant pour les Canadiens. Sommaire de l''emploi: Express Scripts Canada offre une occasion de carrire idale un dentiste qui souhaite largir ses horizons professionnels en utilisant ses comptences en matire d''analyse et d''enqute ainsi que ses connaissances en assurance collective. Le poste de dentiste-conseil temps partiel au sein du Services des audits sur la fraude, le gaspillage et l''abus consiste offrir des services valeur ajoute aux clients d''ExpressScriptsCanada. Le dentiste-conseil doit veiller l''intgrit des demandes de rglement pour soins dentaires et s''assurer que l''entreprise conserve un solide rseau de fournisseurs grce des examens diligents et des conseils. Ce poste implique des dplacements (25%) travers le Canada. Responsabilits principales Rviser les rapports sur les demandes de rglement afin de dceler les demandes de rglement qui prsentent des anomalies ou des incohrences. Effectuer des audits sur place, dans des cabinets dentaires au Canada. Examiner les notes consignes aux dossiers des patients, les radiographies, les factures de laboratoire et rsumer ses constatations. Examiner les rapports d''audit afin d''en assurer la qualit et l''exactitude et de confirmer que le processus d''audit a bien t suivi. Donner une opinion professionnelle afin d''apporter du soutien aux spcialistes des audits. Participer des rvisions par les pairs, au besoin, avec les clients l''externe. Discuter des activits d''audit avec les intervenants l''interne et l''externe. Rviser les critres de risque relatifs la vrification des demandes de rglement et faire des recommandations. Ce que nous recherchons: Possder cinq annes d''exprience rcente dans un cabinet dentaire. tre membre d''une association dentaire provinciale. tre en mesure de grer des renseignements confidentiels. Mettre l''accent sur la qualit et l''exactitude. tre minutieux et possder d''excellentes habilets de communication l''oral comme l''crit. Faire preuve d''intgrit dans tous les aspects de son travail. Possder d''excellentes aptitudes en gestion du temps et avoir un bon sens de l''organisation. Connatre les logiciels de la suite Microsoft Office (Word, Excel et PowerPoint) tre bilingue (franais et anglais), l''oral comme l''crit. Pourquoi se joindre notre quipe? Rmunration, avantages sociaux et rgime de retraite concurrentiels Perfectionnement et avancement professionnels Une culture qui clbre l''innovation et la collaboration Conditions de travail souples et programmes de mieux-tre Exigences pralables l''emploi Toute offre d''emploi est conditionnelle la vrification des rfrences et des antcdents , conformment la politique de l''entreprise. ExpressScriptsCanada, pour certains postes, l''obtention et le maintien d''une cote de fiabilit du gouvernement fdral constituent une exigence d''emploi. Les candidats postulant de tels postes doivent satisfaire tous les critres d''admissibilit pour la cote de fiabilit applicable et consentir au processus de vrification de scurit conformment la rglementation fdrale. Le dfaut d''obtention ou de maintien de la cote de scurit requise entranera le retrait de l''offre ou le congdiement. Nous utilisons des outils d''intelligence artificielle dans le cadre du processus de recrutement, que ce soit pour mener des entretiens vido, prendre des notes et valuer les candidats. Cependant, les valuations seront examines par les gestionnaires responsables de l''embauche et notre quipe Acquisition des talents avant toute dcision. 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 Pharmacy 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. If you require accommodation in completing the online application process, please email: - Do not email - for an update on your application or to provide your resume as you will not receive a response.
Job Title
Bilingual Dental Consultant