Specialist, Claims

3 days ago

Vaughan, Canada Alectra Utilities Full time

The Opportunity

Job Posting Number:
**2024-017**

Position:
**Specialist, Claims & Ability
**Location**:
**Vaughan (Cityview Blvd. or Hamilton (John St.): Remote/In-office)**

Reports to:
**Manager, People Relations & Claims Abilities Management**

Business Unit:
**People & Safety**

Division:
**People & Safety
Hours per Week:
**35**

Rate of Pay:
Number of Openings:
**1**

Union:
**No**

Open:
**May 2, 2024**

Close:
**May 16, 2024**
- Alectra is committed to putting our people first in providing a positive employee experience and a safe work environment. Our Hybrid Workplace policy allows for an effective balance for employees with the opportunity to work in a hybrid environment; a combination of Remote / In-office work based on operational requirements._

**Position Purpose**:
The Specialist, Claims and Abilities is responsible for the effective day-to-day administration, response, and claims management of all occupational and non-occupational illness and injuries. This role leads the accommodation process through planning, implementing and coordinating early and safe return to work programs with applicable internal and external stakeholders, to enhance and support the Company’s Health and Safety culture.

**Key Responsibilities/Accountabilities**:

- Manages and leads the accommodation process through planning, implementing, and coordinating early and safe return to work programs with internal customers - employees, People Leaders, People Services, unions, (if requested), and external customers - WSIB, long term disability provider, Company doctor, and third-party medical vendors.
- Responsible for communication, administration and maintenance of concise records, and confidentiality maintaining and regularly reporting all-inclusive case activity and return to work statistics.
- Provides proactive management to employees of occupational and non-occupation claims, by identifying return to work factors, removing obstacles, and leveraging opportunities to facilitate early and safe return to work.
- Develops and monitors Early and Safe Return to Work programs in accordance with medical reports (CAE - Cognitive Abilities Evaluation, FAF - Functional Abilities Form, MNR - Medical Narrative Request), collective agreements and provincial legislation.
- Monitors progression throughout the program and obtains additional medical documentation when required. Establishes regular touchpoints with employees and People Leaders on suitable work, restrictions, upcoming medical appointments, process, return to work plans and timeframe in the program.
- Prepares reports, letters, and correspondence for non-occupational claims management (preambles for MNR, MNR, doctor to doctor consultation, Independent Medical Evaluation (IME), consent and authorization forms) for illness, injury and working from home accommodations.
- Prepares WSIB Form 7 for occupational illness and injury. Prepares reports, letters and correspondence to WSIB including issues/objections, Second Injury Enhancement Fund (SIEF) requests, and late filing penalties challenges. Send regular updates on employee progress, including updated FAFs and Form 42 - Employer Progress Report.
- Prepares Long Term Disability (LTD) package in the case of a non-occupational illness or injury, including completion of employer statement. Submit monthly Rehabilitation Earnings Statement to LTD Provider when employee returns on a graduated RTW Program. Complete status update monthly report to LTD provider regarding employees off on LTD. Provide regular updates to LTD provider regarding approved claims, claim closures, return to work, and life insurance waivers. Communicates with Canada Life as required to ensure timely and accurate submission of waiver of life insurance premium claims.
- Acts as the point of contact to respond to claim inquiries, both internally and externally, from all levels including management, employees, People Services, union representatives, Payroll, Health and Safety, WSIB, insurance companies, company doctor and 3rd party medical vendors.
- Tracks and manages all claims related data including absence/accommodation history, lost time, return to work dates, review dates, legacy sick bank, LTD monthly report, etc. Develop & maintain effective working relationships both internally and externally with employees, Attend monthly meeting with company doctor and LTD provider to discuss active claims.
- Communicates with the employee, in a timely fashion, regarding an absence related to an occupational or non-occupational event. Explains the roles and responsibilities of the employee, union if applicable, People Leader, and Claims Team. Discusses and offers early and safe return to work. Forwards appropriate forms for completion with timelines for completion.
- Arrange for Independent Medical Exam or 3rd party consult, as required
- Educates People Leaders, employees and unions about the Abilities Management Program on their roles and responsibilities, which

  • Claim Specialist

    2 weeks ago

    Vaughan, Ontario, Canada Alectra Utilities Inc. Full time

    Remote/In-office)Manager, People Relations & Claims Abilities ManagementBusiness Unit:People & SafetyPeople & SafetyOur Hybrid Workplace policy allows for an effective balance for employees with the opportunity to work in a hybrid environment; a combination of Remote / In-office work based on operational requirements.The Specialist, Claims and Abilities is...

  • Claims Specialist

    2 months ago

    Vaughan, Canada Snowbirds Auto Connection Ltd. Full time

    Snowbirds Auto Connection Ltd. is hiring for a part-time claims specialist - SAC has been providing vehicle transportation services for over 30 years :Communicate verbally and written with claimants, the company and relevant parties to document, process, investigate and finalize the automobile claim in a professional mannerExercise judgement to calculate...

  • Claims Specialist

    4 weeks ago

    Vaughan, Canada Snowbirds Auto Connection Ltd. Full time

    Snowbirds Auto Connection Ltd. is hiring for a part-time claims specialist - SAC has been providing vehicle transportation services for over 30 years :Communicate verbally and written with claimants, the company and relevant parties to document, process, investigate and finalize the automobile claim in a professional mannerExercise judgement to calculate...

  • Specialist, Claims

    2 weeks ago

    Vaughan, Ontario, Canada Alectra Utilities Full time

    The OpportunityJob Posting Number: Position:**Specialist, Claims & AbilityLocation:Vaughan (Cityview Blvd. or Hamilton (John St.): Remote/In-office)Reports to:Manager, People Relations & Claims Abilities ManagementBusiness Unit:People & SafetyDivision:**People & SafetyHours per Week:35Rate of Pay:Number of Openings:1Union:NoOpen:May 2, 2024Close:May 16, 2024...

  • Disability Claims Specialist

    2 months ago

    Vaughan, Canada GFL Environmental Inc. Full time

    Reporting to the Manager of Benefits and Disability, the WCB Disability Claims Management Specialist is responsible for proactive end-to-end WCB claims across Canada. The Disability Claims Management Specialist will coordinate claims reporting, tracking, objections, appeals, and facilitate return to work to minimize lost time, while ensuring compliance...

  • Personal Support Worker

    4 weeks ago

    Vaughan, Canada Elite Specialist Group Full time

    Elite Specialist Group is a dynamic organization that deals with Accident Benefit claim assessments, medical devices, in-home care, treatment and therapy for patients who have been in motor vehicle accidents. We are looking for highly motivated and passionate Personal Support Workers for our clients in Brampton. You will be required to assist with daily...

  • Customer Care Claims Specialist

    2 months ago

    Vaughan, Canada CAA Club Group Full time

    Position Details What You Will Do Responsible for investigating and responding to escalated customer concerns and complaints in an effective and timely manner Liaise with Ombudsman’s office to resolve any customer concerns pertaining to Claims handling and settlement Act as a primary contact for various distribution channels i.e. Broker,...

  • Customer Care Claims Specialist

    2 weeks ago

    Vaughan, Ontario, Canada CAA Club Group Full time

    Position Details What You Will Do Responsible for investigating and responding to escalated customer concerns and complaints in an effective and timely manner Liaise with Ombudsman's office to resolve any customer concerns pertaining to Claims handling and settlement Act as a primary contact for various distribution channels i.e. Broker, Direct,...

  • Customer Care Claims Specialist

    4 weeks ago

    Vaughan, Canada CAA Club Group Full time

    Position Details What You Will Do Responsible for investigating and responding to escalated customer concerns and complaints in an effective and timely manner Liaise with Ombudsman’s office to resolve any customer concerns pertaining to Claims handling and settlement Act as a primary contact for various distribution channels i.e. Broker,...

  • Claims Recovery Specialist.

    1 month ago

    Vaughan, Canada Robert Half Full time

    Robert Half currently is searching for a driven Administrative Assistant who is deeply passionate about growing their career in the insurance industry. We are seeking a skilled Administrative Assistant to support our claims processing team on a fully remote basis within the GTA. This role presents an exciting opportunity for individuals with insurance...

  • Senior Claims and Risk Management Specialist

    2 weeks ago

    Vaughan, Ontario, Canada SmartCentres REIT Full time

    Job Title: Risk Manager-Insurance and Real Estate Reports To: Director, Insurance and Risk Management Responsible for assessing, analyzing, and mitigating risks associated with our property management operations, with a particular focus on insurance-related risk exposure.Risk Assessment : Conduct comprehensive risk assessments for various properties managed...

  • Senior Technical Specialist

    4 weeks ago

    Vaughan, Canada CAA Club Group Full time

    Position Details What you will do : Full handle of both direct deal and litigated files Investigate, evaluate, negotiate automobile and property tort loss of moderate to high complexity Manage challenging coverage claims with tact and professionalism Arrange and manage vendors for your investigation (IA's, surveillance, legal defence, defence...

  • Claims Recovery Specialist.

    4 weeks ago

    Vaughan, Canada Robert Half Full time

    Robert Half currently is searching for a driven Administrative Assistant who is deeply passionate about growing their career in the insurance industry. We are seeking a skilled Administrative Assistant to support our claims processing team on a fully remote basis within the GTA. This role presents an exciting opportunity for individuals with insurance...

  • Insurance Quality Assurance Specialist

    2 months ago

    Vaughan, Canada CAA Club Group Full time

    Position Details What you will do: The QA Specialist is a subject matter expert and possesses technical management: Lead the build and execution of the QA programs Perform quality and technical evaluations on technical insurance professionals Perform trend analysis, identify performance gaps and quality improvement opportunities Create and...

  • Insurance Quality Assurance Specialist

    4 weeks ago

    Vaughan, Canada CAA Club Group Full time

    Position Details What you will do: The QA Specialist is a subject matter expert and possesses technical management: Lead the build and execution of the QA programs Perform quality and technical evaluations on technical insurance professionals Perform trend analysis, identify performance gaps and quality improvement opportunities Create and...

  • Senior Claims and Risk Management Specialist

    1 month ago

    Vaughan, ON, Canada SmartCentres REIT Full time

    Job Title: Risk Manager-Insurance and Real Estate Reports To: Director, Insurance and Risk Management Responsible for assessing, analyzing, and mitigating risks associated with our property management operations, with a particular focus on insurance-related risk exposure. Risk Assessment : Conduct comprehensive risk assessments for various properties...

  • Senior Claims and Risk Management Specialist

    4 weeks ago

    Vaughan, ON, Canada SmartCentres REIT Full time

    Job Title: Risk Manager-Insurance and Real Estate Reports To: Director, Insurance and Risk Management Responsible for assessing, analyzing, and mitigating risks associated with our property management operations, with a particular focus on insurance-related risk exposure. Risk Assessment : Conduct comprehensive risk assessments for various properties...

  • Technical Analyst, Disability Claims

    2 weeks ago

    Vaughan, Ontario, Canada Masters Insurance | Financial Full time

    Insurance Technical Specialist Employment Status: Full-Time, Permanent Location: Vaughan Office Keele Street, Suite 400, Vaughan ON, L4K 1Y2 Established in 1966, Masters Insurance is one of Ontario's largest, independently owned brokerages that specializes in insurance and bonding solutions for the construction and development industries. As a rapidly...

  • Freight Accounting Specialist

    4 weeks ago

    Vaughan, Canada Lynden International Logistics Company Full time

    Lynden International Logistics Co., a leader in the field of 3rd party logistics for the healthcare & consumer goods industries. As a leading advocate of operational efficiencies, we take pride in developing customized solution protocols within our systems, to meet the needs of our client partners within the healthcare industry. Lynden International...

  • Freight Accounting Specialist

    1 day ago

    Vaughan, Canada Lynden International Logistics Company Full time

    Lynden International Logistics Co., a leader in the field of 3rd party logistics for the healthcare & consumer goods industries. As a leading advocate of operational efficiencies, we take pride in developing customized solution protocols within our systems, to meet the needs of our client partners within the healthcare industry. Lynden International...