Search for similar jobs in your region
Express Scripts Canada has an exciting opportunity for a Dentist who is looking to expand their career to use their analytical and investigative skills along with their practice and knowledge of benefit coverage. This part-time role in the Business Integrity team enhances the Express Scripts Canada (ESC) value proposition for customers to ensure the integrity of health claims while maintaining a network of providers through diligent review and education.
Review provider claims reports to identify abnormal or inconsistent claims submissions
Perform on-site audits at the provider’s location in Canada
Review & summarize findings from provider chart/clinical notes, radiographs, lab bills, etc.
Review audit reports for quality, accuracy, and proper audit application
Provide clinical opinion to support audit specialists
Participate as ...