Cost Allocation Representative

2 weeks ago

Toronto, Ontario, Canada Workplace Safety and Insurance Board Full time

Provide front-line customer service and problem resolution to employers, workers, the general public and WSIB staff by responding to enquiries relating to Experience Rating Programs; Rate Framework and Accident Cost.

Review Activities via ACES Account & Claims Management (systems) in order to render decisions and process claim cost adjustments and cost reallocation.


Major Duties & Responsibilities

  • Respond to inquiries via Phone Queue, in writing, or ACES and on-line referrals regarding Experience Rating programs; Rate Framework and Accident Cost, from employers, workers, the general public and WSIB staff
  • Assessing the nature of the inquiry and action accordingly or refer to appropriate area or Experience Rating Advisor
  • Respond and decide if action is required regarding incorrectly charged claim to appropriate firm and/or rate/CU (Class/NAICS),
  • Respond to enquires relating to Accident Cost Statement; Experience Rating and Rate Framework statements; explaining data definitions and content on various reports issued by the Branch; and basic rate calculations RFM;
  • Responding to and/or documenting issues, such as, late filing charges, benefits paid, incorrect charges due to incorrect firm/rate (NAICS/Class.; if necessary, refer in writing to the appropriate area to respond;
  • Review incoming activities from ACES Case Management, ACES Account Management Queue and ASD Admin Queue to determine claims history and transfer and reallocate claims as required
  • Assist customers with basic eServices support (example, accessing eStatement and eWISR on line).
Process claims cost adjustments to the correct employer's firm record by:

  • Reviewing requests for cost adjustments and verifying employer information by searching CIR/FRA and ACES to obtain the appropriate Firm/Rate (Class/NAICS) information
  • Referring request to Account Representative/Specialist/Case Manager in cases where a classification review is required and no Form 7 is found on claim file;
  • Notifying employer of decision relating to employer record both verbally and in writing;
  • Identifying and referring noncompliant employers to ESC for further investigation;
  • Notifying Operations staff of changes to industry sector or if a late filing penalty is to be issued.
Complete special cost transfers, such as claims where Second Injury Enhancement Fund (SIEF) relief has been granted, third party recoveries/adjustments, interest payments, supplements, health care removals, training participants, Schedule 2, and transfers to other WSIB administrative house accounts by:

  • Verifying adjustments to benefit cost allocation in IJA (inter-jurisdictional agreement) claims to ensure that costs are allocated to the correct benefit type;
  • Identifying incomplete requests and returning to the appropriate area for clarification;
  • Manually calculating the percentage amount of adjustment/cost transfer per benefit type (i.e., loss of earning, health care, pensions);
  • Making SIEF transfer adjustments when errors are identified or increasing SIEF percentage, then processing adjustment using CIS online screens;
  • Advising employers and their representatives in writing of accident cost transfer.
  • On a rotational basis, review and action the Monthly SIEF Discrepancy Report using CIS online system to process
  • Review system generated reports, such as Industry Change, Firm Closure and Invalid Claims report, to identify and investigate discrepancies and correct accordingly.
  • Review Experience Rating Worksheet or Claim Transfer Memo and triage complex adjustments to Experience Rating Advisor for review and retroactive adjustment if required.
  • Process simple MAP retroactive adjustments as required (residual retroactive adjustments only after 2020)
Provide copies of information/reports to employers, representatives and internal clients in response to requests:

  • Provide Workplace Injury Summary Report replacement letters for newly registered firms
  • Provide explanation letters to external clients regarding correction to WISR reports
  • Verifying authorizations from employer representatives and lawyers;
  • Log and file documents into the Document Management System (TCM using ACES) and Mail Track system
Perform other duties as assigned or required such as:

  • Participating in projects related to the activities of the section.
  • Sort and distribute mail, fax and reports

Job Requirements
Education

  • Post secondary diploma up to three years.
Experience

  • Total of two years experience. One year prior experience in basic accounting or revenue and customer service. One year experience on the job to reach full working level.

Our commitment to equity, diversity and inclusion
We respect and value the diversity of our people. We strive to create an environment where employees can be themselves and where our differences are celebrated.
The WSIB is committed to being accessible and inclusive, and following barrier-free and accessible employment practices

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