Apply claims adjudication and analytical skills with Manitoba Blue Cross in Winnipeg and surrounding areas. Help members understand coverage and resolve claim issues.
As a Member Services Representative, you will process Ambulance/Hospital, Extended Health, Dental, and spending account claims. You will also address inquiries, pre-authorizations, Coordination of Benefits, and missing information. Accuracy, judgment, organization, and professional communication are central to this work.
Key Responsibilities:
- Process claims and pre-authorizations according to performance standards
- Manage pended claims and service-level agreement requirements
- Review processed claims and complete corrective actions
- Return incomplete claims and obtain required additional information
- Complete inquiry tickets, forms, memos, and document management tasks
Requirements:
- Business Administration education or equivalent relevant experience
- Strong problem-solving, analytical, and numerical skills
- Accurate data entry and documentation abilities
- Organizational skills for multiple priorities and deadlines
- Health advantages or healthcare experience considered an asset
Use careful analysis, claims expertise, and member communication to deliver accurate service through Manitoba Blue Cross.
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📌 Member Services Claims Adjudicator (Manitoba)
🏢 Manitoba Blue Cross
📍 Manitoba
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