Analyze healthcare claims as a Healthcare Benefits Auditor using dental expertise and investigative skills in a hybrid Mississauga or Montreal position.
Express Scripts Canada seeks an Auditor for its Fraud, Waste, and Abuse department. You will review provider compliance across dental, vision, mental health, and other healthcare benefits. The work combines claim analysis, provider communication, documentation assessment, and audit reporting.
Key Responsibilities:
Perform claim verifications and desk or in office audits
Assess documentation against perk plans and provincial regulations
Calculate adjustments correcting claim transactions
Prepare detailed, unbiased audit reports
Identify claim trends and recommend risk criteria changes
Requirements:
Licensed dental assistant or dental hygienist graduate
Two to five years in a dental office
Knowledge of dental software, fee codes, and benefits
Valid driver’s license and Canadian travel availability
Bilingual French and English communication skills
Apply dental perks knowledge, critical thinking, and audit skills to protect claim integrity at Express Scripts Canada.