The Workplace Safety and Insurance Board (WSIB) helps people overcome workplace injuries and illnesses and helps business owners make their workplaces safe and healthy. Our people are at the heart of what we do. Bring your enthusiasm and expertise to the WSIB, and we'll help you achieve your personal and professional goals through meaningful work, development opportunities and a culture of compassion, integrity and teamwork.
We are the WSIB. And we're here to help.
WSIB offices remain closed due to COVID-19. Our priority is the health and wellness of employees and the people of Ontario. As such, this position may involve working from home for all or part of the duration of this position.
Perform health care billing compliance audits and reviews by conducting comprehensive claim file reviews, and health care billing analysis to validate health care supplier and provider billing submissions and payments are compliant with WSIB expectations, policies, guidelines and legislation. Provide compliance related education to stakeholders. Identify health care billing compliance trends and anomalies, potential fraud and non-compliance, and make risk based recommendations to Senior Management. Lead Confirmation of Services outreach initiatives, collecting and analyzing information directly from external stakeholders.
Major Duties & Responsibilities:
1. Act as a subject matter expert and resource related to health care billing compliance by:
2. Research, develop, evaluate and provide feedback on new and existing health care billing educational materials for both internal and external stakeholders.
3. Conduct audits and reviews of health professionals WSIB billings and practices to monitor provider compliance with policy, legislative requirements (including WSIA, Criminal Code, Health Insurance Act etc..), administrative practice expectations, billing processes and fee schedules/ This includes:
4. Conducting joint healthcare billing audit reviews with other Ministries, agencies, professional collegse, or other billing service providers by:
5. Conduct Confirmation of Services initiatives related to health care billing compliance by:
6. Develop health care billing compliance audit processes, guidance documents, training and presentation materials. Provide training and educational presentations to new hires and internal partners related to health care billing compliance.
7. Other related duties as assigned or required.
As a precondition of employment, the WSIB will require a prospective candidate to undergo a criminal records name check prior to or at any time following hire.
To apply for this position, please submit your application by the closing date noted above.
We appreciate the interest of all candidates. Due to the volumes of applications we receive, we are only able to contact candidates that are selected to move forward in the recruitment process. The WSIB is an equal opportunity employer.
The WSIB is an equal opportunity employer and provides accommodation for job applicants in accordance with the Human Rights Code and the Accessibility for Ontarians with Disabilities Act. If you are an individual with a disability and you need accommodation in order to apply for this position, please contact firstname.lastname@example.org. If you are invited to participate in the assessment process, please provide your accommodation needs at that time. Please be advised that you may be required to provide medical documentation to the WSIB's Corporate Health Department so that appropriate accommodation can be provided to you throughout the recruitment process.
Employees of the WSIB have important ethical responsibilities, including the obligation to place the public interest above personal interests. Job applicants are therefore required to disclose any circumstance that could result in a real, potential or perceived conflict of interest. These may include: political activity, directorship or other outside employment and certain personal relationships (e.g. with existing WSIB employees, clients and/or stakeholders). Please contact TAC if you have any questions about conflict of interest obligations and/ or how to make a disclosure.
Personal information will be collected from your resume, application, cover letter and references under the authority of the Workplace Safety and Insurance Act, 1997 and will be used by the Talent Acquisition Centre and WSIB hiring parties to assess/validate your qualifications and/or determine if you meet the requirements of vacant positions and/or gather information relevant for recruitment purposes. If you have questions or concerns regarding the collection and use of your personal information, contact the WSIB Privacy Office, 200 Front Street West, Toronto, ON, M5V 3J1 or 416-344-5323 or 1-800-387-0750 extension 5323. Be advised that information related to application status will not be provided.