Disability Claims Management Specialist

2 months ago


Burnaby, British Columbia, Canada Pacific Blue Cross Full time
About Pacific Blue Cross

Pacific Blue Cross is a leading benefits provider in British Columbia, dedicated to keeping healthcare sustainable for all British Columbians. As a not-for-profit society, we prioritize the well-being of our members and strive to make a positive impact on the community.

Job Summary

We are seeking a highly skilled Disability Claims Management Specialist to join our Work & Wellness department. This role involves providing 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
  • Review, analyze, and investigate claims information from various sources to determine eligibility and make informed decisions.
  • Develop and implement case management plans, including cost-benefit analyses, to identify the most effective approach to managing disability claims.
  • Coordinate referrals to internal stakeholders for rehabilitation and external service providers to facilitate recovery and return-to-work initiatives.
  • Manage claimant and client relationships, providing timely responses to inquiries and escalating non-W&W concerns to appropriate areas within PBC or other Blue Crosses.
  • Participate in conference calls with selected groups to build trust and facilitate relationship building.
Requirements
  • 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, with 2 years in a Disability Claims Specialist or Disability Claims Management Specialist 1 position.
  • Demonstrated proficiency in basic Word and Excel.


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