Bilingual Disability Management Coordinator

We are seeking a Bilingual Disability Management Coordinator to join our Organizational Solutions team (OSI).

The Bilingual Disability Management Coordinator is responsible for overseeing the full lifecycle of disability management and accommodation claims, with consults on all complex claims prior to adjudication decision. The role involves conducting a detailed functional assessment, reviewing medical and workplace documentation, adjudicating claims in accordance with organizational and client policies, and providing initial consideration of the return to work on every claim. Maintain accurate and timely documentation and billings within the internal claims management system, and ensure that all claim activities, communications, and next steps are clearly documented and communicated to the client.

This role has a strong focus on facilitating an early, safe return to work by developing and monitoring individualized recovery and transitional return-to-work plans. This includes collaborating with healthcare providers, other key support service partners, health providers, and employers (clients) to optimize treatment and workplace accommodations. Additionally, the role requires ongoing client engagement, participation in strategic discussions, quality reviews, and continuous improvement initiatives.

The Bilingual Disability Management Coordinator will:

• Manage all non-complex and complex disability management and accommodation claims, including but not limited to psychological claims, multiple diagnoses, and co-morbid conditions

• Complete claim consults with designated individuals on all complex claims prior to the adjudication decision on the claim

• Conduct detailed phone functional interviews regarding activities of daily living (ADL) while providing tips to reduce barriers

• Evaluate medical and workplace information to determine if key elements are present

• Execute adjudication of all claims in accordance with client and OSI policies, and with a high degree of excellence

• Request clinical notes in any claim that requires additional clarity, including mental health claims with pre-existing documentation, identified workplace concerns, unique circumstances, etc.

• Enter detailed information regarding the claim, status, billings, communications, and next steps into the internal claims management system

• Ensure a Care Management Action Plan is in place on all files, as required

• Review and respond to client instant messages received in the internal claims management system within one (1) business day of receipt

• Manage all claims by developing outcome-focused recovery and return-to-work plans that facilitate an early, safe return to work while minimizing claim duration.

• Determine when additional tools are to be used at the appropriate times, including IME, FCE, referral to rehabilitation, medical consultant, pharmacogenetics, cognability, or workstation evaluations, etc.

• Interact with various key support service partners and health providers to enhance claim outcomes, facilitate treatment plans, and ensure the claimant is receiving optimal treatment at all times

• Maintain regular communication with clients to ensure they are kept informed of claim status throughout the claims management process

• Communicate the employee’s functional capabilities to the employer to determine if the employer is able to provide modified duties in the return to work planning

• Facilitate and monitor Transitional Return to Work Plans (TRTWPs) to support successful return-to-work outcomes.

• Complete file reviews with the designated Team Lead on any claims over 30 days

• Assist with other ad hoc claims and duties as needed

• Record all billable and non-billable time in the internal claims management system

• Participate in monthly client calls and meetings as require

• Demonstrated ability to collaborate effectively with internal and external stakeholders, contributing to a team-oriented environment while supporting client needs and ensuring service continuity

• A strong commitment to performance excellence, accountability, and professional development, while supporting colleagues, achieving key performance metrics, and contributing to continuous improvement initiatives.

To be successful as the Bilingual Disability Management Coordinator with OSI, you will need:

• Completion of post-secondary education in a related field including healthcare, nursing, rehabilitation sciences, disability management, human resources, occupational health, health and safety, business, insurance, legal and paralegal studies, or an equivalent combinatio