Team Manager overseeing audits and investigations for dental and healthcare providers at Alberta Blue Cross. Leading a team to ensure compliance with billing agreements and reporting findings.
Responsibilities
Act as the primary resource for your assigned team, monitor audits and investigations, and ensure audits and investigations, including all reporting meet all required standards.
Proactively address internal and external clients’ needs that are escalated to you and help your team to prioritize work items to meet client service standards.
Responsible for the management of the day-to-day activities of team members including workload management, audit and/or investigative direction, coaching and mentoring.
Establish and continuously enhance best practices guidelines for the successful delivery of the audits and investigations.
Maintain a positive, collaborative team which inspires high productivity and encourages the generation of new ideas and enhanced work processes.
Recommend and implement changes to processes, policies, and procedures to optimize service delivery and enhance productivity.
Recruit, train, mentor, and coach team members, with an end goal of retaining a work force of the highest quality for both the team and our organization.
Actively participate in the planning and implementation of Claims Audit and Investigation Services operational initiatives.
Requirements
Post-secondary education preferred in police studies, criminal justice, law, commerce, or related studies.
Comprehensive understanding of major case management principles.
Ability to employ and train advanced investigative techniques.
An audit or investigation designation such as ACFI or ACFE is required (candidates with extensive relative experience will be considered in lieu of education).
Five years plus experience in investigations and/or auditing.
Three years plus leadership experience is an asset.
Exceptional communication skills, including written and verbal.
Experienced in investigation interviewing.
Commitment to quality customer service is required for success in this position.
Ability to work well independently as part of a virtual team, with a strong sense of responsibility and accountability.
Experience in the health care benefits industry is desirable.
Benefits
Exceptional customer experience
Community leadership
Opportunities for career growth
Inclusive employer
Job title
Team Manager – Claims Audit, Investigation Services
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