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Disability Claims Management Expert 2
3 months ago
Disability Claims Management Specialist 2
About Pacific Blue Cross
Pacific Blue Cross (PBC) has proudly served as British Columbia's premier benefits provider for over 80 years. As an independent, not-for-profit organization, we have deep connections within BC's health care system. Our offerings include health, dental, life, disability, and travel coverage, benefiting 1 in 3 British Columbians through both employee group plans and individual plans. Our commitment is to ensure sustainable health care for all British Columbians. Through the PBC Health Foundation, we support initiatives aimed at enhancing health outcomes, particularly in mental health and chronic disease management. We seek individuals who aspire to make a meaningful impact and are eager to advance their careers with us.
Perks
- Flexible working hours promoting work-life balance, with a standard of 7 hours per day, Monday to Friday (totaling 35 hours per week).
- Starting paid vacation of 3 weeks annually, increasing with tenure.
- Hybrid work model, combining both office and remote work.
- Comprehensive benefits package, including extended health, dental, and life insurance, fully covered by PBC.
- Pension contributions from the company after one year of employment.
- Annual education allowance of up to $1,000.
- Access to an onsite gym, cafeteria, and 24/7 virtual healthcare services through our Employee Family Assistance Program.
Job Summary
- We are in search of a Disability Claims Management Specialist 2 to contribute to our Work & Wellness department.
- This role is part of a unionized environment under the CUPE 1816 Bargaining Unit, with hourly compensation that aligns with the Collective Agreement. The initial wage for this position is $35.85 per hour.
Job Responsibilities
Disability Claims Adjudication, Assessment, Intervention, and Case Management
- Delivers comprehensive professional services for disability and waiver of premium claims.
- Conducts telephone interviews with relevant parties involved in the disability claims process.
- Develops and implements case management strategies, coordinating referrals to both internal and external resources.
- Verifies the accuracy of system-generated payment calculations.
- Addresses appeals for denied claims.
- Maintains communication with re-insurers for claims that exceed established limits.
Customer, Client, and Member Service
- Plans and organizes the content of written communications and reports.
- Manages relationships with claimants and clients, ensuring they are kept informed of decisions.
- Actively engages in conference calls with designated groups.
- May participate in onsite visits with clients.
General Team and Department Support
- Stays informed about best practices in disability management.
- Provides support to colleagues and assists in the onboarding of new team members.
- Performs additional duties related to disability claims management as assigned.
Qualifications:
- High school diploma or equivalent.
- Completion of a 1-year Disability Management Diploma (288 hours) or equivalent.
- Proficient in basic Word and Excel applications.
- A minimum of 3 years of relevant experience in disability claims management.
- Demonstrated expertise in disability claims management, including assessment and resolution of claims.
