Disability Claims Management Specialist

2 months ago

Mississauga, Canada Russel Metals Full time

Russel Metals is one of the largest metals distribution companies in North America, with a growing focus on value-added processing. It carries on business in three segments: metals service centers, energy field stores and steel distributors. Its network of metals service centers carries an extensive line of metal products in a wide range of sizes, shapes and specifications, including carbon hot rolled and cold finished steel, pipe and tubular products, stainless steel, aluminum and other non-ferrous specialty metals. Its energy field stores carry a specialized product line focused on the needs of energy industry customers. Its steel distributors operations act as master distributors selling steel in large volumes to other steel service centers and large equipment manufacturers mainly on an "as is" basis.

**Reasons to Join Our Team**
- Opportunity to be part of a dynamic and highly motivated team where you can develop your potential and launch an exciting career.
- We recognize that our employees are our greatest asset and for that reason, we reward those who share our work ethics and values with personal growth and career opportunities.
- We support our employees through a range of financial and non-financial rewards and benefits including medical benefits, retirement programs, share purchase plans, tuition assistance to name just a few.
- Potential to work on a hybrid basis once fully trained; 50% in-office and 50% remote

**How You Will Make a Difference**:
The Claims Management Specialist supports the Canadian business units and employees in reviewing and administering non-occupational injury and illness recovery and return to work. Supporting the development and implementation of a corporate process to effectively manage disability claims. Provides support and guidance to the field and will directly manage complex claims. Will work with vendors, employees and managers to ensure safe and early return to work. Will support file management as well which may include appeals, non-participation by claimant and requirements for independent medical review. Will engage HR Advisor team and/or business leader when required for escalation.

**How Will You Spend Your Time**:

- **Claims Management**
- For complex, unusual or high frequency claims, manage the claims, including gathering information from employees about their accident or illness, work with managers for return to work. and transition from STD to LTD when applicable.
- Working with managers, insurance providers and employees to ensure objective, fair and thorough claim administration adjudication, comply with practices and procedures and regulatory requirements,
- Determining whether claims are eligible for coverage under the terms of each insurance policy
- Reviewing claims for concerns, proper follow-up by 3rd party.
- Reviewing and gain approval for settlement offers when approached by insurers.
- For complex claims, maintain contact with medical providers to monitor the status of injured workers and their claims; and they must also consult with medical professionals to determine the cost of a treatment plan and the benefit it will provide to the claimant.
- Directly manage third party reporting, case reviews for WIB/STD, premium waivers as appropriate and engage 3rd party support where required.
- **Return to Work**
- Working with Occupational Injury Disability Specialist, this role will support programs, which include work hardening, Independent Medical Review, retraining, physical therapy, retraining services for claimants
- For escalated files, may facilitate employee re-integration to the workplace through planning, implementation and coordinating timely modified work programs include placement of employees with complex accommodations needs.
- May establish contact with employees with complex files who are ill or requesting medical accommodation and serves as the single point of contact for centralized communication and coordination of the accommodation/treatment/rehabilitation plan.
- **Process, Statistics and Data**
- Claims Specialist will report on claims, illness and RTW statistics and evaluates injury reports to assess compensation and to determine the anticipated cost of each claim.
- Updating documents and policies related to this process on the internal website
- Provides managers with information and training regarding workers compensation benefits.
- Identify opportunities to flag repetitive issues, branches struggling and ongoing modified duties and help develop action plans to improve.
- **Budget and Payments**
- Reviews costs identifying concerning trends, review and recommend for approval settlement proposals.
- Specialist will ensure medical treatments are necessary and cost-effective.
- Preparing invoices for field for payment by the Corporate Accounts Payable department within authorized limits.
- **Education and Compliance**
- The Specialist will maintain current knowledge of regulations and legislation that affects worker's

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