Analyst, Claims Quality- remote

4 weeks ago

Waterloo ON, Canada Ontario Teachers Insurance Plan Full time

Reporting to the Group Life and Disability Claims Manager,you’ll be responsible for:
Key decisions and the development of specific case management plans on all long-term disability (LTD) and life waiver claims within an assigned caseload. Reviewing and analyzing contractual and medical information on new LTD claims, while managing an ongoing block of active, complex LTD claims.
Engaging in professional interactions with members, affiliates, boards and other stakeholders, on a regular basis regarding decisions, rehabilitation opportunities as well as timely and efficient follow-ups to telephone end email communications.
Ensuringinformation is accurate and meets productivity, quality and service goals.
Workingin partnership with Disability Benefits Coordinators to obtain claim information, ensuringbenefit payments are accurate and approvals and terminations are processed in a timely manner.
Utilizinginternal and external resources, such as medical consultants, lawyers, vocational and functional rehabilitation specialists, WSIB assessors and technical experts, as necessary, to progress files forward to resolution
Three to five years’ experience in insurance or long term disability claim adjudication.
Post-Secondary Education (diploma, degree or certificate) is required in health sciences or related field, such as nursing, physical therapy, occupational therapy and exercise physiology or kinesiology.
CDMP (Certified Disability Management Professional) will be considered an asset.
A strong understanding of insurance principles and practices, industry standards, legal and contractual obligations, and claims investigation and assessment procedures.
Intermediate knowledge of Microsoft Office Suite applications.
Ability to multi-task and work in a dynamic and fast paced environment demonstrating superior oral and written communication skills, in addition to solid organizational skills.
The ability to communicate in French will be considered an asset.
We offer best-in-class pension and benefits, total reward programs and comprehensive mental wellness supports to set you up for every success in and outside of work. Defined benefit pension plan for a financially confident retirement
~100% coverage of approved continuing education and licensing fees (including RIBOcourses in Ontario)
~ Flexible work-from-home and hybrid options
~ If you are interested in this opportunity, please apply online.
Upon individual request, we will endeavor to remove any barrier to the recruitment and selection processes and provide accommodations for persons with disabilities.

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