Bilingual MAC Dental- Special Authorization Analyst at Medavie

, Prince Edward Island, Canada -

Full Time

Start Date

Immediate

Expiry Date

31 Jan, 26

Salary

0.0

Posted On

02 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Bilingual, Dental Knowledge, Customer Service, Data Entry, Time Management, Communication Skills, Decision Making, Organization, Teamwork, Telecommunications, Claims Processing, Problem Solving, Attention to Detail, Professional Judgment, Technology Use, Client Liaison

Industry

Hospitals and Health Care

Description

Position Type: Permanent If you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place. As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year. Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today. The Opportunity If you are looking for an opportunity in a challenging, fast-paced and team-oriented work environment with a leading local organization, the career you’ve been looking for may be waiting for you at Medavie Blue Cross. The Federal Administered Programs (FAP) Medical Authorization Centre- Dental specializes in the authorization and reimbursement of dental benefits. As a MAC Dental, Special Authorization Analyst you will develop a high level of knowledge in the programs we administer. In this role you will respond to requests from clients and providers in both official languages. At this time, the work environment may be at home or in the office depending on the current situation. Shifts may vary during the hours of operations of the Medical Authorization Centre-Dental, between 8:00AM – 6:00PM, Monday to Friday. Key Responsibilities • Receive, pend, and process requests for dental services that require special authorization consideration, and prepare packages that require review from dental consultant; • Administer processes for special authorization decisions through the interactive use of telecommunications and applied on-line technology; • Call and or draft requests for additional information from dentist and/or dental specialists for more information/diagnostics when necessary, or requested by the dental consultant; • Update requests according to decisions rendered to allow for real time adjudication when the dental treatment authorized is rendered; • Create and send the appropriate decision letter to the client and/or provider to notify them of the outcome of their request; • Utilizes dental background, knowledge, and experience to assess requests; • Liaison with the customers and other health care professionals to ensure treatment requests are appropriately administered; • Provides a positive and efficient customer service experience for providers and clients. The successful candidate will demonstrate the ability to: • Have the ability to work quickly and accurately under pressure of time restraints; • Have the ability to work on your own and as a team member; • Be well organized, with excellent time management skills; • Have excellent oral and written communication skills; • Demonstrate mature and professional judgment and decision making ability. As the ideal candidate, you possess the following qualifications: Education: Successful completion of a recognized post-secondary Dental Assisting or Dental Hygiene program. Work Experience: The ideal candidate will have a minimum of 2 years experience in a dental environment. Experience working in an office and or customer service experience would be considered an asset. Other Qualifications: Experience with quick and accurate data entry and knowledge of claims processing, eligibility and claims systems would be considered an asset Computer Skills: Experience working with the Microsoft Office Suite Language Skills: Must be fluently Bilingual (English and French) both written and verbal in-order to provide services to our customers and communicate with internal stakeholders in both official languages. Security Clearance Requirement: In conjunction with our contract with the Federal Government, you will be required to have Reliability Status Clearance (Enhanced Level B). This includes Fingerprinting, Criminal Record Check, Credit Check and you must have resided in Canada for at least 5 years and hold Permanent Resident or Citizenship Status. #CBM1 We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted. If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca. We're recognized as one of Canada's best places to work and are a leading provider of health solutions and insurance for 1 in 10 Canadians. Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match. Full careers. Full lives. Medavie is a national health solutions partner and innovative leader in healthcare delivery, benefits management, health management, and primary care. Backed by the strength of a team of 8,500+ professionals from coast to coast, we’re committed to improving the wellbeing of Canadians so that every life can be lived to the fullest. Medavie provides all-in-one private health insurance, public health administration, emergency medical services as Canada's largest contracted provider, as well as primary care, community health, mental health and addictions solutions, medical communications, and clinical training. As a not-for-profit organization, Medavie is one of Canada’s Top 100 Employers, certified by Imagine Canada for philanthropy and community engagement, and Rainbow Registered as an organization that champions diversity, equity, and inclusion.

Responsibilities

The Special Authorization Analyst will process requests for dental services requiring special authorization and prepare packages for review by dental consultants. They will also liaise with clients and providers to ensure efficient service delivery and maintain accurate records of decisions made.