Claims Examiner, Prior Authorization

Permanent Full Time 

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This position is suited to an individual who works well both independently and as part of a team, in an environment that is constantly changing.  The Prior Authorization Coordinator, Drug Services is responsible for assessing coverage of drugs that require prior authorization before allowing coverage under a group drug plan.  The incumbent reviews medical information based on guidelines in place, and in consultation with the Medical Board must determine if coverage can be approved or declined.  Once the decision is made, they must communicate the results both verbally and in writing to the plan member. 

Our current work environment supports a Hybrid-Flex work arrangement that includes some rotational in-office (minimum 2 days) & work from home capability.  

What you will do:

• Review medical information submitted by the patient’s physician to determine if all the necessary information has been received in order to complete the assessment.  If not, must correspond with either the plan member or the physician to obtain any missing information. 

• Determine, based on the group plan parameters, if coverage is eligible under the group plan. 

• Review the medical information and determine if further investigation with the Medical Board is required or if the assessment can be made based on the information available to you. 

• Correspond both by phone and in writing with plan members to advise and support the decisions made. 

• Provide support to the Great-West Life Group Offices, Sales & Marketing Centers, Benefit Payment Offices, and Group Customer Contact Services regarding prior authorizations. 

What you will bring:

• Living our values of Customer View; Integrity; Partnership; and Communities 

• Ability to deliver high quality results with speed and accuracy in a fast paced challenging and ever-changing work environment 

• Strong organizational, quality and time management skills 

• Excellent analytical, investigative and problem-solving skills 

• Strong customer service skills  

• Excellent verbal and written communication skills 

• Experience working in Excel, Word and Access.  Excellent keyboarding skills of 40wpm 

• At ease navigating through multiple computer programs simultaneously 

• Knowledge of the insurance industry and exposure to drug plans will be considered an asset 

• Knowledge of BEN, TOCs, TSO and Cybrary will be considered an asset 
• Bilingualism (English and French) is considered an asset 
• Reliability Status security clearance - this is a personnel security status that is required before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website 

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The base salary for this position is between  $39,100.00 - $52,800.00 annually.  This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc).  If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.

Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.

Be your best at Canada Life- Apply today!

Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.

You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.

Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.

Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations. 

We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. 

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Canada Life policies. To request a reasonable accommodation in the application process, contact talentacquisitioncanada@canadalife.com.

Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted.

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