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Disability Claims Specialist
2 months ago
About Pacific Blue Cross
Pacific Blue Cross (PBC) is British Columbia's leading benefits provider with over 80 years of experience. As an independent, not-for-profit society, we are deeply rooted in BC's healthcare system. We provide health, dental, life, disability, and travel coverage to one in three British Columbians through employee group plans and individual plans. Our commitment is to ensure sustainable healthcare for all British Columbians. Through our PBC Health Foundation, we fund projects that directly improve health outcomes related to mental health and well-being, as well as the prevention and management of chronic diseases.
Perks at Pacific Blue Cross
- Enjoy a healthy work-life balance with flexible working hours of 7 hours per day, Monday to Friday (35 hours per week).
- Benefit from paid vacation starting at 3 weeks per year, increasing with years of service.
- Embrace a hybrid work environment, combining both office and remote work days.
- Access generous benefits including extended health, dental, and life insurance; PBC covers 100% of these premium costs.
- Receive company pension contributions after 1 year of service.
- Utilize an education allowance up to $1,000 per calendar year.
- Enjoy on-site amenities like a gym, cafeteria, and access to virtual doctors/counsellors 24/7 through our Employee Family Assistance Program.
Job Summary
We are seeking a dedicated Disability Claims Management Specialist 2 to join our Work & Wellness department. This position is unionized and part of the CUPE 1816 Bargaining Unit. The starting wage for this position is $35.85 per hour, with wage increases in accordance with the Collective Agreement.
Job Duties
- Disability Claims Adjudication, Assessment, Intervention and Case Management:
- Provide comprehensive disability and waiver of premium claims services.
- Conduct telephone interviews with stakeholders involved in the disability claims process.
- Develop case management plans and coordinate referrals to internal and external stakeholders.
- Verify system-generated payment calculations for accuracy.
- Respond to appeals for declined claims.
- Maintain liaison with re-insurers for claims exceeding specified limits.
- Customer, Client, and Member Service:
- Plan the content of written correspondence and reports.
- Manage claimant and client relationships by keeping them informed of decisions.
- Actively participate in conference calls with selected groups.
- May attend onsite visits with clients.
- General Team and Department Support:
- Maintain up-to-date knowledge of disability management best practices.
- Support other team members and new employees.
- Perform other assigned duties related to disability claims management.
Qualifications:
- High school graduation, or equivalent.
- Completion of a 1-year Disability Management Diploma (288 hours), or equivalent.
- Demonstrated proficiency in basic Word and Excel.
- 3 years of previous related experience in disability claims management.
- Proven proficiency in disability claims management, including assessment and claim resolution.
