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. 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 . 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. Hybrid work environment, flexible work schedules. Casual dress code to promote diversity and inclusivity.

Personal and professional development. The position encompasses both responding to diverse and complex inquiries from customers in person and by telephone, as well as assessing, adjudicating, and processing claims.The incumbent requires extensive knowledge of all of the company’s products and administrative practices relating to company procedures. Respond to a variety of customer inquiries adhering to the principal of first call resolution wherever possible.

Enrollment and billing procedures. Claims procedures and claims payments. Plan specific inquiries related to Ambulance/Hospital, Extended Health, Travel, Dental, Health Spending Account, Wellness Spending Account and Vision Care.

Confirm coverage, explain benefits and ensure claim requirements are explained and understood by both members and providers. Check for processed claims for dental offices, hospitals, pharmacies, and various other health providers and members, including resolution of any issues and performing any corrective action. Accurately adjudicate and process standard and diverse Ambulance/Hospital, Extended Health, Dental, Health Spending Account,



Wellness Spending Account and Vision Care claims and pre-authorizations in accordance with performance standards.

Assist in the management of pended claims in the Claims Workplace as assigned. Ensure claims/queries for clients with Service Level agreements are adjudicated within the standards set out in the agreement. Manage and update Coordination of Benefits (COB) information, ensuring the correct adjudication of claims.

Return claims for completeness of information and communicate with members and providers to obtain any necessary additional information whenever possible. Remain current and knowledgeable about benefits which are provided by the Provincial Health Care Plan, particularly in respect to prescription drugs, travel health and vision care. Promote and sell Travel products.

Assist members with registration and navigation of the online portal. Accept and forward customer suggestions and complaints about all aspects of Blue Cross, including billing and enrollment, claims, products and/or benefits. Prepare for and deal effectively with customers who contact our office following radio programs, newspaper articles, mass mailings, etc.

Assist the Customer Service Centre with in-person inquiries as required. Assist with replying to customer emails if required. Assist in directing customers to the appropriate source (i.e.: Assist Travel Agents and General Agents in selling, extending and refunding Travel Health, Trip/Holiday Cancellation and the Tour Package Plan as well as explaining coverage information and claims procedures.

Maintain an awareness of changes to employer group plans in order to respond to customer inquiries. Accurately adjudicate and process standard health and dental claims. Manage and update Coordination of Perks (COB)



information, ensuring the correct adjudication of claims.

Return claims for completeness of information and communicate with members and providers to obtain any necessary additional information whenever possible. Remain current and knowledgeable about benefits which are provided by the Provincial Health Care Plan, particularly in respect to prescription drugs, travel health and vision care. Mail and administrative duties (sorting, scanning, indexing, document management).

Dedicated to the principles of exceptional service; committed to responding to, anticipating, and addressing customer needs, for both internal and external customers Post-secondary education in Business Administration or a related field (University degree or Community College diploma), or an equivalent combination of education and relevant experience. Proven ability to provide high-quality customer service while maintaining accuracy in data entry and documentation. Excellent written, verbal, and interpersonal communication skills, with strong active listening and relationship-building capabilities.

Strong attention to detail, with the ability to maintain accuracy and confidentiality in a service-driven environment. Strong computer proficiency, including Microsoft Word, Excel, and email applications, with the ability to learn new systems quickly. Several years of experience providing direct service to members, clients, or the general public in a professional setting.

Experience in member services, insurance, healthcare, or a related customer-focused industry is considered an asset. Knowledge of health benefits, pharmacy, medical products, dental services, and related terminology, or completion of a medical certificate program, is considered an asset. Proficiency in a second language is considered an asset.

Manitoba Blue

Cross is committed to the principles of diversity, equity & inclusion and to promoting opportunities in hiring for everyone. We want our workforce to reflect the diverse community we serve, and we're committed to creating a fair and respectful workplace.

📌 Customer service representative needed ASAP (Manitoba)
🏢 Manitoba Blue Cross
📍 Manitoba