Audit extended healthcare claims for Express Scripts Canada in hybrid Mississauga work, using analytical skills and provincial coverage knowledge. This contract role reviews providers across Canada.
The Extended Healthcare Claims Auditor supports the Fraud, Waste, and Abuse department through claim verification and provider audits. The work requires healthcare experience, investigative thinking, documentation assessment, and knowledge of benefit plan design. Pharmacy Assistants and Pharmacy Technicians may apply clinical knowledge to this insight-driven work. You will communicate findings, calculate corrections, and identify risks.
Key Responsibilities:
- Perform desk, on-site, and claim verification audits
- Assess provider documentation against plans and regulations
- Calculate adjustments correcting claim transactions
- Prepare reports and summarize audit recoveries
- Identify trends and recommend risk criteria changes
Requirements:
- Two to five years recent healthcare environment experience
- Accredited pharmacy education; RPhT designation preferred
- Valid driver's license and Canadian travel availability
- Analytical, critical thinking, and investigation capabilities
- MS Office proficiency and confidential information management
Apply healthcare auditing, claims analysis, and provider communication skills as Express Scripts Canada's Mississauga-based auditor.
Healthcare Claims Auditor Mississauga employer: Cigna Health and Life Insurance Company
Express Scripts Canada Pharmacy in Mississauga is an exceptional employer that prioritizes the well-being of its employees while fostering a collaborative and supportive work culture. With competitive pay, a comprehensive total rewards package, and ample opportunities for professional growth, you will be empowered to make a meaningful impact on patient care and contribute to better health outcomes for our members.
Contact Details:
Cigna Health and Life Insurance Company Recruitment Team
