Bilingual Claims Management Specialist
4 weeks ago
SP Data Digital is seeking a Bilingual Disability Claims Manager to oversee our claims operations. The Claims Manager utilizes best practices in disability management to effectively handle the financial aspects, expenses, and risks associated with both short-term and long-term disability claims within designated authority limits. The role operates under established procedural guidelines and is supported by moderate supervision from the Manager of Life and Disability Claims.
Why consider this opportunity?
- Supportive Environment - We prioritize work-life balance and aim to create a workplace that supports both personal and professional development.
- Meaningful Contributions - Engage in projects that positively influence our clients, the organization, and the broader community.
- Skill Development - This position provides a platform for enhancing your professional skills while directly impacting your business unit.
- Technical Growth - An opportunity to refine your technical and functional abilities.
Key Responsibilities
- Assess, analyze, and determine eligibility for initial and ongoing claims payments based on medical documentation, job criteria, non-medical considerations, contract stipulations, and industry protocols while adhering to service standards.
- Manage the duration of active claims by applying industry best practices.
- Conduct interviews with claimants and employers via telephone.
- Ensure accurate and timely record-keeping of all communications with clients.
- Develop and execute a comprehensive case management strategy for each claim, focusing on a timely, sustainable, and safe return to work; engage with treating physicians and employers appropriately; refer for independent medical evaluations and to other insurance entities.
- Work collaboratively with internal return-to-work facilitators to design and oversee return-to-work initiatives.
- Collaborate with colleagues to share insights, gather information, and propose solutions regarding claims.
- Maintain proactive communication with clients about the status and progress of their claims in line with departmental standards.
- Ensure successful resolution of claims and favorable outcomes.
Qualifications
- Bilingual proficiency in French and English is required.
- A university degree in anatomy, biology, kinesiology, life sciences, or psychology.
- A minimum of three years of experience in disability claims management.
- Familiarity with medical terminology and best practices in disability management.
- Understanding of relevant provincial employment laws and regulations.
- Proficient in word processing, spreadsheet, email, internet, and database applications.
- Completion of LOMA 280, 290, HIAA, CEBS - GBA courses is considered an asset.
- Strong verbal and written communication skills, along with excellent interpersonal and customer service abilities.
- Ability to work independently and collaboratively, prioritize tasks, and effectively research, analyze, evaluate, negotiate, and resolve issues.
- Capability to apply policy terms and adjudication guidelines.
Beyond Compensation
For regular full-time roles, SP Data Digital offers a comprehensive rewards package that includes:
- Competitive salaries with annual increases, ranging from $65,000 to $80,000 based on experience.
- An annual bonus program recognizing both company performance and individual contributions.
- A robust employer-funded benefits package starting from day one, including life insurance, disability coverage, health and dental plans, and a generous health spending account.
- Flexible work arrangements and personal health days.
- Four weeks of annual vacation from the start date.
- A defined contribution pension plan with substantial employer matching.
- Top-up programs for parental and compassionate leave.
- Wellness and recognition programs sponsored by the employer.
- A cash referral program for employee recommendations.
Commitment to Diversity
SP Data Digital is proud to be an equal-opportunity employer. We celebrate diversity and are dedicated to creating an inclusive environment. We encourage applications from individuals of all backgrounds and experiences, even if you do not meet every qualification listed. All applicants will receive equal consideration without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, disability, or age.
We welcome applications from individuals with disabilities and are committed to providing accommodations upon request during the screening and selection process.
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