Analyst I – Clinical Drug Services

Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. We’re committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. We believe in what we do—and place trust in our employees to deliver our vision. Working at Alberta Blue Cross® means having a career where you’ll be recognized for your contributions. We value diversity, encourage our team members to maintain a healthy work-life balance and provide opportunities for career growth. OVERVIEW: We currently have a temporary (18-month) opportunity for a Special Authorization Analyst I in our Clinical Drug Services department. With the direction of the Team Manager, this position is responsible for providing support to the Clinical Drug Services department as well as delivering exceptional special authorization service to our customers within established standards for turn-around. Special Authorization is a process whereby physicians can request coverage for specific drugs for their patients. WHAT YOU WILL DO: Research applicable patient coverage. Indexes documents into an electronic workflow and storage system. Assesses and renders decisions on select special authorization requests according to established guidelines based on drug(s) requested and medical condition(s). Determines and interprets appropriate system entry and correspondence required. Enters information on Alberta Blue Cross computer systems regarding requests for special authorization in order to enable appropriate claims adjudication. Prepares and proofreads correspondence related to Special Authorization. Handles telephone inquiries from internal and external customers. Assists with other duties and projects as required. WHAT YOU WILL HAVE: Post secondary education in a health or related administrative program (i.e. Medical Office Administration certificate or diploma, Pharmacy Technician) or directly related experience. Excellent written and verbal communication skills, as well as strong organizational skills, are required. Must be accurate and pay close attention to detail. Computer proficiency, particularly with Microsoft Office (i.e. Word, Excel, and preferably Access and SharePoint/Teams) is required. Must be customer oriented and a strong team player. Must possess strong analytical and decision making skills. Must have a demonstrated ability to manage time effectively and work with minimum supervision in a team environment. Must have demonstrated ability to meet challenges of heavy workloads and frequent change. Knowledge of drug names is required. Familiarity with medical terminology would be an asset. This position will remain open until a suitable candidate is selected. Alberta Blue Cross® is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences. We offer the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, apply online at careers.ab.bluecross.ca A criminal record check satisfactory to Alberta Blue Cross will be required as a condition of employment, following a conditional offer.

The analyst is responsible for assessing and rendering decisions on special authorization requests for drug coverage according to established guidelines. They also manage electronic documentation, perform system entries for claims adjudication, and handle customer inquiries.

Candidates must have post-secondary education in a health or administrative program, such as a Medical Office Administration certificate or Pharmacy Technician diploma. Strong analytical, communication, and computer proficiency skills are required, along with knowledge of drug names.

• Career growth opportunities • Work-life balance

• Customer servicePreferred

Identified from the job description. Confirm important requirements above.

• Clinical drug services
• Special authorization
• Claims adjudication
• Medical terminology
• Data entry
• Analytical skills
• Decision making
• Microsoft Office
• Word
• Excel
• Access
• SharePoint
• Teams
• Communication skills
• Organizational skills
• Customer service
• Community Leadership
• Office Administration
• Energetic
• Proofreading
• Workflow Management
• Organizational Skills
• Advocacy
• Microsoft Excel
• Research
• Adjudication
• Decision Making
• Customer Service
• Innovation
• Medical Terminology
• Microsoft SharePoint
• Time Management
• Verbal Communication Skills
• Detail Oriented

• Healthcare
• Administrative
• Customer Service & Support
• Drug Clerk
• Medical Claims Processor / Representative
• Debt Collectors and Related Workers
• Insurance Claims and Policy Processing Clerks

Minimum education

Professional degree

Minimum experience

0+ years

Posting language

English

Working hours

40 hours per week