Bilingual LTD Claims Consultant

3 weeks ago

Montreal, Quebec, Canada OTIP RAEO Full time

Job Summary

We are seeking a highly skilled Claims Consultant for Long-Term Disability Services to join our team at OTIP RAEO. As a key member of our team, you will be responsible for providing exceptional service and support to insured members throughout the long-term disability claims process.

Key Responsibilities

  • Provide service, support, and guidance to insured members throughout the LTD claims process, including meeting with them in person, virtually, or telephonically to answer questions, provide guidance, and complete forms.
  • Guide insured members through the LTD appeal process by obtaining and coordinating appeal documentation and rationale, communicating with medical practitioners, local union representatives, and other stakeholders as required.
  • Provide assistance to insured members in obtaining other income replacement benefits, such as Canada Pension Plan disability benefits, by applying for CPP benefits and appealing the CPP's decision if required.
  • Build, maintain, and strengthen relationships with local and provincial unions, seeking to better understand their needs, establish trust, and continuously improve the level of service provided.
  • Establish a professional image of the organization for insured members, local unions, medical practitioners, school boards, and other stakeholders, promoting OTIP RAEO in a positive manner and building and maintaining positive interactions.
  • Obtain a comprehensive understanding of medical information and corresponding claim decisions on file and provide insured members and local union representatives with detailed and thorough explanations of the issues.
  • Adhere to documented service standards and identify opportunities for improvement, detecting gaps in key processes, recommending solutions, and implementing process improvements to achieve a higher level of quality service.
  • Coach and mentor other team members and contribute to the success of the department's stated objectives, identifying short- and long-term goals, providing relevant and timely information during discussions, recommending appropriate courses of action, and participating in or leading special projects as required.
  • Maintain interdepartmental communication and workflow while fostering a spirit of cooperation, focusing on member services and processes that cross department lines and providing opportunities for service enhancements.
  • Respond to stakeholder enquiries regarding the ongoing LTD claims process, reviewing timelines, external communications, and correspondence for accuracy.
  • Exercise tact and diplomacy to effectively resolve difficult situations, negotiating through conflicts and contentious claim issues among stakeholders.
  • Keep information confidential to protect operations.

Requirements

  • Post-secondary education
  • A minimum of five years' experience in Group Disability Insurance
  • Strong knowledge of insurance principles and practices, industry standards, and legal and contractual obligations
  • Exceptional communication skills and the demonstrated ability to deal effectively with all levels of internal and external stakeholders
  • The demonstrated ability to use negotiating techniques to effectively resolve complex conflicts
  • Superior time management and organizational skills to manage competing priorities, including project management skills
  • Intermediate knowledge of Microsoft Office Suite applications
  • Insurance courses are considered an asset
  • The ability to communicate in French is considered an asset
  • A valid driver's license is required

About OTIP RAEO

OTIP RAEO is a company that values its employees and strives to create an accessible and inclusive work environment. We are committed to learning and evolving to celebrate what makes us special. We are an equal opportunity employer and encourage applications from all qualified individuals.

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