Position Type:
Permanent

If you're looking for a fulfilling career that can make a real difference in your life, and the lives of others, you've come to the right place.

As a national health solutions partner, we put people first in everything we do - and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.

Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest - and it's reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.

The Opportunity

We have an exciting opportunity for you to join our Provider Audit unit as an Audit Investigator. Whether you have prior experience in audit or health care, you can use your analytical skills to identify and address abnormal claiming patterns among healthcare providers of our company's drug, hospital, extended-health, and dental benefit programs. Work closely with service providers and customers to ensure transparency and efficiency, and be part of a dynamic team that values continuous learning and development.

Responsibilities

• Lead and Execute Audits: Plan, perform, and lead claims audits and investigations.
• Utilize Advanced Analytics: Apply query analytics and software to detect inappropriate claims.
• Conduct Thorough Investigations: Perform comprehensive audits, from pre-audit to final reporting, and present findings to management and regulatory bodies.
• Communicate Findings: Summarize and report findings, recommendations, and corrective actions clearly and effectively.
• Foster Strong Relationships: Build and maintain collaborative relationships with colleagues and customers to drive continuous improvement and risk mitigation.
• Commit to Continuous Learning: Stay updated with industry practices and enhance your audit skills and knowledge of insurance and healthcare principles.
• Engage in Unique Projects: Lead and assist in various risk-based projects, contributing to the overall success of the team.

Requirements

• Professional experience in a healthcare field (Nursing Assistant, Dental Assistant, Vision Care, etc.) or relevant experience working with medical documentation.
• Advanced proficiency in Microsoft Excel.
• Demonstrated computer skills (including word processing, spreadsheets, flowcharts, etc.).
• Excellent initiative, problem solving, and analytical skills.
• Ability to articulate thoughts in a clear and concise manner (both verbal and written).
• Ability to manage multiple competing priorities and tight deadlines.
• Ability to travel across Canada 3-4 weeks per year (non-consecutive).
• Valid Driver's license.
• English is requirement, written and verbal, to provide services to our customers and communicate with internal stakeholders.

Assets

• Knowledge of audit principles, practices and methodologies acquired preferably through 1-3+ years of experience in auditing and/or investigative practices.
• Use of data analytics software (e.g. ACL, Excel, etc.), along with an ability to learn and apply statistical inference and data sampling principles to large data populations would be idea.
• Professional designation in fraud detection, auditing or investigative techniques (e.g. CPA, CA, CMA, CGA, CIA, CFE, etc.).
• Financial Services experience would be an asset, preferably within the insurance and/or healthcare industry.
• Bilingualism (English/ French)

We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws . We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.

If you experience any technical issues throughout the application process, please email: [email protected] .