Group Short Term Disability Claims Specialist

3 days ago

Waterloo, Canada Equitable CA Full time

At Equitable, we realize that your work life is not just about performing a job; it's about being part of a workplace that helps you grow and reach your full potential. Within our friendly and collaborative work environment, we recognize that the key to our growth and success is a dedicated, motivated and client-responsive staff. Join Equitable today.
**Position Title**: Group Short Term Disability Claims Specialist
**Reports To**: Manager, Life STD LTD Claims
**Department**: Group Disability Life Claims
**Term**: Permanent Full-Time
**Work Arrangements**: This is a hybrid role. You will work in our office in Waterloo, ON a minimum of two (2) assigned, consecutive days every other week, plus a fifth (5th) assigned day per month. You are welcome to work from the office more than the minimum requirement and there may be some roles that are required to work in our office more than the minimum requirement.
**The Opportunity**: If you love helping people and have a passion for delivering exceptional customer service, you’d be a great fit for our team. That’s because at Equitable, we believe in providing personalized service and support to our plan sponsors and plan members. Our plan sponsors rely on us to deliver creative solutions as we help their staff in their recovery and return to work from an injury or illness. If you have experience in disability adjudication or in a related disability or mental health profession and you want to have a positive impact on the lives of our plan members, we want you to join our company.
We’re looking for a polished communicator and decision maker who can develop creative solutions to complex problems, someone who is empathetic and has a natural service orientation, who is a collaborator that can work with others towards a common goal. If that’s you, why not explore a career as a Disability Claims Specialist at one of Waterloo Region’s Top Employers for 2024?
**What you will be doing**:

- Analyze medical, functional, employment and contractual information to make timely and accurate decisions on STD claims
- Continually manage open STD claims using proficient problem solving and analytical skills and creating opportunities for timely resolution of the claim
- Calculate benefits payable and make any adjustments as required throughout the course of the STD claims. (i.e., offset for CPP Disability Benefits and calculating overpayments, etc.)
- Identify and implement cost effective case management tools to assist disabled employees (e.g., Rehabilitation Intervention, Functional Abilities Evaluations, Independent Medical Examinations, Medical Consultant Referrals)
- Provide superior written and verbal customer service with accuracy and maintain well-documented, clear, and concise files
- Frequently communicate with plan sponsors, plan members, advisors, Group Marketing Managers, medical professionals, legal professionals
- Actively participate in client meetings
- Utilize key problem-solving skills to make tough decisions on claims, clearly communicating these decisions with the client in a way that is easy to understand
- Showcase conflict resolution skills to de-escalate situations with unsatisfied clients

**What you will bring**:

- Proficient English, spoken and written, is required
- 2+ years’ STD and/or LTD claims management experience is preferred
- University degree or College Diploma preferred in health-related field (i.e. nursing, occupational therapy, kinesiology, psychology, social services etc.) or experience adjudicating disability claims
- Thorough knowledge of insurance operations
- Passion for problem-solving and thorough knowledge of insurance operations
- Complex knowledge of various group contracts would be helpful
- Computer literacy skills
- Effective negotiating and conflict management skills
- Excellent interpersonal and strong customer service skills
- Mathematical & analytical skills
- Demonstrated conflict management and professional de-escalation skills
- Deep-rooted personal boundaries and time management, with the ability to balance various priorities coming in at once
- Ability to break down difficult to understand concepts/decisions and explain in a way that is easy to understand for the client
- Proven ability to succeed in a dynamic environment with changing priorities

**What’s in it for you**:

- A healthy work-life balance with employee wellness top of mind
- Annual bonus program, annual vacation allowance, and company-paid benefits program
- An additional paid volunteer day each year so you can spend time giving back to the community
- Immediate enrollment in the company’s pension program with employer matching
- Employee resource groups that support an inclusive work environment
- Tuition support and specialized program assistance
- An onsite full-service cafeteria with a variety of daily options
- Discounts on company products and services, and access to exclusive employee perks
- Regular EQ Together events focused on company togetherness

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