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Pacific Blue Cross is a leading benefits provider in British Columbia, offering health, dental, life, disability, and travel coverage to over 1 million British Columbians. We are an independent, not-for-profit society with a strong commitment to keeping healthcare sustainable for all.
Job SummaryWe are seeking a Disability Claims Management Specialist to join our Work & Wellness department. This role will provide professional disability and waiver of premium claims services to insured clients and Administrative Services Only (ASO) applicants, ensuring claims are coordinated and managed within contractual terms and conditions of eligibility and coverage.
Key Responsibilities- Provide full range of professional disability and waiver of premium claims services to insured clients and ASO applicants
- Review, analyze, and investigate claims information from various sources, determining adjudication, assessment, and intervention actions
- Develop cost/benefit analyses and case management plans to identify most cost-effective approach to managing disability claims
- Coordinate referrals to internal stakeholders for rehabilitation and external service providers
- Develop and implement return-to-work initiatives and conduct reviews of ongoing cases
- Respond to appeals for declined claims and maintain liaison with reinsurers when benefits exceed specified limits
- High school graduation or equivalent
- Completion of a 1-year Disability Management Diploma or equivalent
- 3 years of previous related experience in disability claims management
- Demonstrated proficiency in basic Word and Excel
This is a unionized position, part of the CUPE 1816 Bargaining Unit. The starting wage for this position is $35.85 per hour. We offer a hybrid work environment, flexible working hours, and a comprehensive benefits package, including extended health, dental, and life insurance.
