Ltd Claims Consultant

7 months ago

Waterloo, Canada Ontario Teachers Insurance Plan (OTIP) Full time

Company Description

OTIP (Ontario Teachers Insurance Plan) is a member-focused, service-driven organization. We are committed to putting our people first by fostering a positive and inclusive work environment, providing a competitive total compensation package and investing in career development. Our team is currently looking for a:
**LTD Claims Consultant / Disability Service Representative**

**Job Description**:

- Guides insured members throughout the LTD appeal process by obtaining and coordinating appeal documentation and rationale. This includes communicating with medical practitioners, local union representatives and other stakeholders as required.
- Builds, maintains and strengthens relationships with local and provincial unions. Seeks to better understand the unions’ needs, establish trust, and continuously improve the level of service provided.
- Establishes a professional image of the organization for insured members, local unions, medical practitioners, school boards and other stakeholders. This includes promoting OTIP in a positive manner, building and maintaining positive interactions, and developing and/or performing public relations activities.
- Obtains a comprehensive understanding of medical information and corresponding claim decisions on file and provides insured members and local union representatives with detailed and thorough explanations of the issues.
- Adheres to documented service standards and identifies opportunities for improvement. This includes detecting gaps in key processes, recommending solutions, and implementing process improvements to achieve a higher level of quality service.
- Coaches and mentors other team members and contributes to the success of the department’s stated objectives. This includes identifying short-and long-term goals, providing relevant and timely information during discussions, recommending appropriate courses of action, and participating in or leading special projects as required.
- Maintains interdepartmental communication and workflow while fostering a spirit of cooperation. This includes focusing on member services and processes that cross department lines and providing opportunities for service enhancements.
- Responds to stakeholder enquiries regarding the ongoing LTD claims process. This includes reviewing timelines (in view of the documented service standards) external communications and correspondence for accuracy.
- Exercises tact and diplomacy to effectively resolve difficult situations. This includes negotiating through conflicts and contentious claim issues among stakeholders.
- Keeps information confidential to protect operations.

**Qualifications**:

- Post secondary Education
- A minimum of five years’ experience in Group Disability Insurance.
- Strong knowledge of insurance principles and practices, industry standards and legal and contractual obligations.
- Exceptional communication skills and the demonstrated ability to deal effectively with all levels of internal and external stakeholders.
- The demonstrated ability to use negotiating techniques to effectively resolve complex conflicts.
- Superior time management and organizational skills to manage competing priorities, including project management skills.
- Insurance courses are considered an asset.
- The ability to communicate in French is considered an asset.
- Valid driver’s license is required

Additional Information
**What we offer**:

- Competitive salary and bonus structure
- Industry-leading employer-paid group benefits that start on your first day
- Defined benefit pension plan
- 100% coverage of continuing education and licensing fees (including RIBO and AIC courses)
- Flexible work from home and hybrid options
- Opportunities for advancement
- OTIP and its group of companies strive to create an accessible and inclusive work environment where everyone is treated with respect and dignity. Upon individual request, we will endeavour to remove any barrier to the recruitment and selection processes and provide accommodations for persons with disabilities._
- As a business, we protect what matters most to our members. As an employer, we value what matters most in our workplace. Together, this includes fostering a diverse, equitable and inclusive environment for all. We are committed to learning and evolving so we can continue to celebrate what makes us special. You are who you are, and our differences are what make us unique._

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