Disability Claims Management Specialist
1 month ago
Pacific Blue Cross (PBC) has been a leading benefits provider in British Columbia for over 80 years. As an independent, not-for-profit society, we have strong roots in BC's health care system. We provide health, dental, life, disability, and travel coverage to 1 in 3 British Columbians through employee group plans and individual plans.
Our MissionWe are committed to keeping health care sustainable for all British Columbians. Through our PBC Health Foundation, we fund projects that improve health outcomes directly related to mental health and wellbeing as well as the prevention and/or management of chronic disease. We are interested in finding people who want to make a difference and who are looking to grow their career with us.
Perks- Work-life balance with flexible working hours of 7 hours per day, Monday to Friday (i.e., 35 hours per week).
- Paid vacation starts at 3 weeks per year, and increases with years of service.
- Hybrid work environment (i.e., a combination of work from office and work from home days).
- Generous benefits, including extended health, dental, and life insurance; these benefit premiums are 100% paid by PBC.
- Education allowance up to $1,000 per calendar year.
- Onsite gym, cafeteria, and access to virtual doctors/counsellors 24/7 via our Employee Family Assistance Program
We are searching for 1 Temporary up to 12 months Disability Claims Management Specialist 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.
Job SummaryUnder the general supervision of the Supervisor, Work & Wellness (W&W), the Disability Claims Management Specialist provides the full range of professional disability and waiver of premium claims services to insured clients and Administrative Services Only (ASO) applicants undergoing review, and ensures claims are coordinated and managed within contractual terms and conditions of eligibility and coverage.
Key Responsibilities- Provides the full range of professional disability and waiver of premium claims services to insured clients and ASO applicants undergoing review, and ensures claims are coordinated and managed within contractual terms, conditions of eligibility, and coverage.
- Responds to appeals for declined claims in accordance with established processes.
- Maintains liaison with re-insurers when benefits exceed specified limits.
- Plans the content of and composes a variety of written correspondence and reports which adhere to the established standards of business communications, internal style guidelines, privacy legislation and confidentiality considerations.
- Manages claimant and client relationships by keeping employers, third party administrators, union and trustee representatives informed of all decisions, and providing timely responses to inquiries.
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 with 2 years in a Disability Claims Specialist or Disability Claims Management Specialist 1 position, or equivalent. Demonstrated proficiency in disability claims management including assessment, oversight of interventions and claim resolution.
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