Disability Claims Specialist

Join to apply for the Disability Claims Specialist role at Pacific Blue Cross. Pacific Blue Cross (PBC) has been British Columbia’s leading benefits provider for over 80 years. We are an independent, not-for-profit society with strong roots in BC’s health care system, offering health, dental, life, disability, and travel coverage to 1 in 3 Brit-columbians through employee group plans and individual plans. We are committed to keeping health care sustainable for all British Columbians and support community well-being through the PBC Health Foundation. Perks Work-life balance with flexible working hours of 7 hours per day, Monday to Friday (35 hours per week). Paid vacation starting at 3 weeks per year, increasing with years of service. Hybrid work environment (combination of office and home days). Generous benefits, including extended health, dental, and life insurance; premiums 100% paid by PBC. Company pension contributions after 1 year of service. Education allowance up to $1,000 per calendar year. On‑site gym, cafeteria, and 24/7 access to virtual doctors/counsellors through the Employee Family Assistance Program. About the Position This is a temporary, unionized role (CUPE 1816) at hourly rates, with the monthly wage ranging from $5,038 to $5,880. The position reports to the Supervisor, Work and Wellness (W&W) and provides professional disability claims services to clients and applicants. Job Summary Under the general supervision of the Supervisor, W&W, the Disability Claims Specialist reviews, analyzes, and investigates short-term disability claims, determines adjudication and assessment actions, generates payments, and communicates outcomes to clients, applicants, and internal stakeholders. Job Duties Review, analyze, and investigate claims and claimant history to determine eligibility information. Interpret and apply contract wording, medical documentation, claims policies, and statutory requirements to short-term disability claims. Initiate regular telephone contact with claimants, employers, doctors, and other stakeholders to gather additional information. Plan and compose written correspondence and documents that adhere to business communication standards. Adjudicate claims, key data into systems, document contacts and actions, process payments, and maintain files. Act as a liaison with Finance on third-party claims to identify overpayments and follow up on repayment. Identify and calculate amounts for recovery from WorkSafe benefits, other income sources, motor-vehicle accident claims, and earlier return-to-work arrangements; communicate recovery amounts and follow up to ensure collection. Prepare and present pending short-term disability claims and related recommendations to the disability team for review. Monitor and update claims continuously, identifying impacts of changing conditions and recommending suspension of benefits when required; communicate decisions directly to clients and applicants. Compose written correspondence detailing decisions, including reasons for denial. Verify salary and manage tax deductions, payment dates, EOB notes, accruals, garnishments, and automated payment setups for approved future dates. Respond to general inquiries by phone and email to maintain client relationships and retention. Log statistics for productivity metrics and maintain up-to-date knowledge of disability management practices, policies, and procedures. Support new employees by demonstrating specific tasks and sharing knowledge upon request. Perform other assigned duties related to disability claims, adjudication, and administrative support not affecting job rating. Qualifications High school graduation or equivalent. Completion of a 1-year Disability Management Diploma (288 hours) or equivalent. Proficiency in Microsoft Word and Excel. Typing speed of at least 40 wpm. Two years of related experience, including at least one year in a Disability Claims Administrator, W&W or Benefit Representative, or equivalent. Decision-making and critical thinking skills. Oral and written communication skills. How to Apply If you’re excited about this opportunity, please apply today at http://www.pbchbs.com/company/careers/. Diversity, Equity, and Inclusion Pacific Blue Cross is an Indigenous Works employer of choice, an Insurance Business Canada Diversity, Equity, and Inclusion award winner, one of Canada’s Greenest employers, a Canadian Centre for Diversity and Inclusion partner, and a Pride at Work partner. We strive to create a workplace where everyone feels valued and empowered to contribute regardless of race, ethnicity, gender, sexual orientation, religion, ability, education level, parental status, or socioeconomic status. We are an equal‑opportunity employer and welcome applications from all qualified candidates. To request an accommodation in completing this job application, testing, interviewing, or otherwise participating in the employee selection process, please direct your inquiries to careers@pac.bluecross.ca. Accommodation requests will be reviewed confidentially on a case-by-case basis by Human Resources. #J-18808-Ljbffr