Experience Rating Advisor

4 weeks ago

Toronto, Canada Workplace Safety and Insurance Board Full time

As primary point of contact, provide technical expertise and advice on all aspects of Rate Framework program specific to claims impact to rates and Experience Rating Programs.
Review and revise claims cost changes to determine impacts to employers’ rates and initiate Premium Rate Calculator to obtain potential rate changes. Communicate decision in writing to employer.
Render decision on claim or account retroactive changes pertaining to Experience Rating Programs (MAP; CAD7; NEER)
**Major Duties & Responsibilities**
1. Manage assigned caseload of employer accounts via multiple channels by:

- Review, validate or revise claim costs in cost reallocation data in order to initiate PRC (Premium Rate Calculator) to determine if employers are eligible for premium price adjustments and if allowable, PRC will adjust premium to current or prior years
- Reviewing claim decisions on ACES Claim Centre, clarifying with Case Manager in case of discrepancies or decisions not implemented (i.e. third party transfers, SIEF, various types of benefits such as LOE, health care, pensions
- Calculating and completing simple/complex manual Experience Rating adjustments and claim cost adjustments for Rate Framework purposes
- Preparing detailed documentation including recommendation sheets for authorization relating to Claim Cost Reallocation, PRC and Experience Rating adjustments for employer file as required;

2. Manage objections to Experience Rating Programs and Premium Rate calculations impacting claims decisions by:

- Reviewing WSIAT/ Appeals decision to determine whether reconsideration is warranted;
- If decision being upheld, informing parties of the right to appeal and explaining the appeals process;
- Processing objection by arranging access to claim files if necessary, updating employer file and referring to Appeals Branch;
- Implementing Appeals/WSIAT decisions specific to Experience Rating programs and PRC with claims, within specified timeframes.

3. Provide customized presentation/workshops to employers as it relates to Premium Rate calculations and claims impacting their account.
4. Prepare claim cost estimates (What if scenarios) for employers or internal staff (RTW), to assist and influence employer outcomes in early and safe return to work practices by:

- Providing financial impact projections by creating customized scenarios based on actual or hypothetical situations demonstrating the financial impact of workplace accidents and delayed return to work for employers, their representatives and WSIB staff;
- Providing financial impacts of multi-account organizations with respect to mergers/amalgamations and other complex issues.

6. Perform other related duties as assigned or required, such as:

- Undertaking special projects and assignments, individually or as part of the team, to research, analyze and compile information related Experience Rating and claims related Rate calculations

**Job Requirements**
Education
- University completion at undergraduate level.

Experience
- Total of five years experience. Two years prior experience in accounting, business, customer service, claims, communication, finance and/or WSIB revenue/accounts. Three years 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 in compliance with the Accessibility for Ontarians with Disabilities Act (AODA). Should you require accommodation through any stage of the recruitment process, please let us know when we contact you and we will work with you to meet your needs.
**Disclosing conflicts of interest**
**Privacy information

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