Claim Adjudicators

2 weeks ago


St John's, Newfoundland and Labrador, Canada WorkSafeNB Full time
The team at WorkSafeNB is passionate about promoting health and safety in New Brunswick workplaces. We strive to make New Brunswick the safest place to work.

However, injuries do occur, and when they do, we are committed to providing caring recovery and return to work services, benefits, and compensation to injured workers and their families.

Culture is the heartbeat of the organization. The stronger it is, the further we go Selected by our employees, our WorkSafeNB values shape our culture. We put our values of Accountability, Collaboration and Trust into ACTion.

We demonstrate accountability by taking pride in and ownership of our work so we can take care of our clients and other New Brunswickers.

Through collaboration, we build strong partnerships and innovate to achieve better outcomes. Trust guides our organization; we lead and listen with empathy and embrace diversity, inclusion and belonging. These ACTions shape us.

WorkSafeNB is looking to hire permanent and term contract positions for Claim Adjudicators.

The normal hours of work for employees in the bargaining unit shall be thirty-five hours per 5-day workweek, Monday to Friday, between 8:00 a.m.

and 5:00 p.m.

Reporting to the Manager, Adjudication Services, you will provide superior client service by rendering quality decisions in a timely fashion on claim entitlement and providing timely access to care for workers.

This includes medical aid and loss of earnings entitlement.

You will support the worker in their recovery and enable the worker to stay at work and/or return to work.

To protect the integrity of the system, you will make decisions in compliance with Workers' Compensation Act or any other relevant legislations, and WorkSafeNB policies, directives, and standard operating procedures.


Your key areas of responsibility include:

  • Providing quality and timely decisions on claim entitlement in keeping with established service standards by claim type for all new claims, reconsiderations and recurrences while maintaining compliance with legislation, policies and procedures.
  • Communicating the adjudication decisions clearly and concisely by preparing decision letters, in a timely fashion, for the workers, employers, service providers, etc. anchored into legislation and policies.
  • Gathering and requesting any information and evidence required to complete and weigh it, using administrative justice principles, to ensure quality and timely adjudication decisions are made in accordance with legislation, policies, and standard operating procedures.
  • Evaluating and determining if new incoming information is material and substantial and a claim decision should be reconsidered or if a new decision is required.
  • Utilizing disability duration guidelines to educate and create expectation regarding stay at work and return to work options with workers, employers, and service providers. Initialize stay at work or return to work processes.
  • Initiating, supporting, authorizing, and setting-up the medical rehabilitation plan (including return to work plans) in accordance with legislation, policies, and standard operating procedures.
  • Evaluating and taking appropriate action on incoming information.
  • Identifying issues impacting the claim, recovery, and stay/return to work and coordinate appropriate referrals when indicated.

You embrace the following competencies:

  • Clientfocused Service
  • Teamwork and Collaboration
  • Adaptability
  • Ensuring Accountability
  • Decision Making
  • Analytical Thinking
  • Written Communication
  • Information Gathering and Processing
  • Resilience
  • Legislation and Compliance


  • St. John's, Newfoundland and Labrador, Canada Canada Life Assurance Company Full time

    Group Benefits Examiner**Description: - Permanent Full Time- We are hiring for a Claims Examiner in St. John's, Newfoundland.- What you will do:Reviewing, investigating, and adjudicating Canadian Health and Dental claims in accordance with Group policy contracts Conducting telephone calls to health and dental service providers for incomplete claims...


  • St. John's, Newfoundland and Labrador, Canada Personnel Search Ltd Full time

    DIRECTOR, CREDIT AND COLLECTIONS Saint John, NB Our client has a great opportunity for a Director, Credit and Collections. As Director, Credit and Collections you will be part of a large finance group of +220 employees. The Director, Credit and Collections reports to the Senior Director, Shared Services and leads all aspects of the credit and...


  • St. John's, Newfoundland and Labrador, Canada Personnel Search Ltd. Full time

    DIRECTOR, CREDIT AND COLLECTIONSSaint John, NB Our client has a great opportunity for a Director, Credit and Collections.As Director, Credit and Collections you will be part of a large finance group of +220 employees.The Director, Credit and Collections reports to the Senior Director, Shared Services and leads all aspects of the credit and collection...


  • St. John's, Canada Canada Life Assurance Company Full time

    **Job Description**: We are looking for a **_Group Benefits Examiner in the St. John's, Newfoundland office._** If you want to be rewarded for individual performance and contributions, Canada Life offers you the opportunity to begin an enriching and challenging career with our Claims Examiner team. You will be supported and rewarded for achieving clear...


  • St. John's, Canada Canada Life Assurance Company Full time

    Group Benefits Examiner **Description: - Permanent Full Time- We are hiring for a Claims Examiner in St. John's, Newfoundland.- What you will do: - Reviewing, investigating, and adjudicating Canadian Health and Dental claims in accordance with Group policy contracts - Conducting telephone calls to health and dental service providers for incomplete claims...


  • St. John's, Canada Intact Full time

    Nos employés sont au cœur de ce que nous faisons de mieux : aider les gens, les entreprises et la société à aller de l’avant dans les bons moments et à être résilients dans les moments difficiles. En vous joignant à notre équipe, vous contribuerez à ces efforts aux côtés de gens expérimentés et passionnés. Intégrez un milieu où vous...