Pharmacy Provider Relations Representative - Contact Centre in Canada Creek, Nova Scotia at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Pharmacy Provider Relations Representative – Contact Centre based in Canada.

This role serves as a key point of contact between healthcare providers and a health benefits organization, ensuring accurate, timely, and professional support regarding claims, eligibility, and benefit plan inquiries. You will handle inbound calls from pharmacies, dental offices, and other healthcare providers, helping them navigate benefit rules, claim submissions, and adjudication outcomes. The position requires strong communication skills and the ability to resolve complex inquiries while maintaining a high standard of customer service. You will also support continuous process improvement by identifying workflow enhancements and sharing provider feedback with internal teams. This is a fast-paced, detail-oriented contact centre environment where accuracy, empathy, and problem-solving are essential. The role offers the opportunity to contribute directly to improving provider experience and service quality across a large member base.

• Respond to inbound inquiries from healthcare providers regarding benefit eligibility, plan coverage, prior approvals, claim status, and submission requirements.
• Verify and process claims using online adjudication and claims management systems.
• Accurately document all provider interactions and ensure proper logging of call details and outcomes.
• Investigate and resolve complex inquiries by conducting research and analyzing claim or eligibility data.
• Provide feedback and insights to management to support workflow improvements and service enhancements.
• Assist in supporting operational projects using tools such as Microsoft Excel and Word for reporting and analysis.
• Maintain high-quality customer service while ensuring compliance with organizational policies and procedures.

• Previous experience in customer service, preferably in a call centre or healthcare-related environment.
• Strong communication and interpersonal skills with a professional and empathetic telephone manner.
• Proficiency in Microsoft Office applications, particularly Word and Excel.
• Ability to analyze information, troubleshoot issues, and resolve complex inquiries independently.
• Familiarity with pharmacy, dental, or medical terminology is considered a strong asset.
• High attention to detail, strong organizational skills, and ability to work in a fast-paced environment.
• Proven ability to take ownership of issues and deliver accurate information consistently.
• Strong commitment to delivering excellent customer service and continuous learning.

• Competitive compensation aligned with Canadian contact centre and healthcare service roles.
• Comprehensive health and wellness coverage supporting employees and their families.
• Opportunities for professional growth and career development within a stable organization.
• Supportive, team-oriented work environment focused on collaboration and inclusion.
• Work-life balance with structured scheduling in a contact centre setting.
• Exposure to healthcare benefits administration and provider relations operations.