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Case Manager

2 months ago

Toronto, Ontario, Canada CIE_101 Beneva Inc. Full time

Job Summary

CIE_101 Beneva Inc. is seeking a seasoned bilingual Disability Case Manager to manage a mixture of short and long-term disability claims. As a Disability Case Manager, you will be responsible for managing a case load of claims, making decisions on these claims, reviewing medical documentation, building return to work plans, liaising with rehabilitation services, and providing excellent customer service to claimants and all other parties involved.

Key Responsibilities

  • Analyze all information relevant to determining Beneva's obligations, including contract provisions, medical proof, non-medical factors, government programs, legislation, internal policies, and procedures.
  • Contact all agents involved in a given file to obtain all relevant information and provide them with decisions and action plans related to settlement requests.
  • Make appropriate and careful selection and use of internal and external interventions, including cases referred to consulting physicians, supervisors, rehabilitation firms, medical experts, residual capacities evaluation firms, investigation firms, reinsurers, etc.
  • Interact with external agents to ensure they respect the objectives and budgets provided and ensure the intervention is progressing well.
  • Provide customer service on files assigned to you by answering calls from all parties involved in the files.
  • Develop and implement interventions that reduce the duration of disabilities.
  • Interact with computer systems to update data and make payments, when applicable, taking contract details and internal directives into account.
  • Participate in meetings with policyholders for a critical review of files as required.
  • Recommend measures to improve the sector's service and productivity performance.
  • Proactively acquire and improve knowledge of tools, policies, processes, products, and services.
  • Carry out certain technical and administrative tasks to support file management.
  • Collaborate on specific projects, upon request.
  • Carry out any other administrative tasks upon request.

Requirements

Education

  • College or University degree, specifically in Administration, Kinesiology, or Health sciences is an asset.

Experience

  • 3 to 5 years of experience in disability claims adjudication and disability claim management within an insurance company.

Skills

  • Excellent command of spoken and written English and French.
  • Strong knowledge of insurance contracts.
  • Able to work independently and collaboratively at all levels.
  • Strong organizational skills.
  • Good analytical, decision-making, and problem-solving skills.
  • Excellent prioritization skills.
  • Ability to adapt to change and quickly integrate new knowledge.
  • Willingness to collaborate in reaching common objectives.
  • Ability to work under pressure and manage priorities.