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Disability Case Manager

2 weeks ago

Chilliwack, Canada TeksMed Services Inc. Full time

The Return to Work Coordinator reports directly to the RTWC Team Manager. Their daily responsibilities include the management of new and ongoing WCB/WSBC/WSIB claims and provide direction and advice to clients in the areas of claims management and return-to-work (RTW). Your duties are to communicate with the employer (client), reviewing and analyzing information provided by the Administration team, and to challenge WCB/WSBCWSIB as appropriate on entitlement issues.

When a factor arises that may result in the delay of RTW or add potential costs to the claims of an employer, you will intervene and take appropriate action to ensure the potential claim costs are mitigated. You are also expected to communicate with the injured worker, the treating physicians (including physiotherapists and/or chiropractors), and the WCB/WSBC/WSIB to assist in facilitating a safe and smooth return-to-work for the worker. This process includes coordinating with each party to ensure the necessary information is collected, accurate and received in reasonable time.

The main challenge is to ensure the best action is taken for the worker and the employer by determining if modified duties are available and appropriate for the worker, or if further medical diagnosis is needed.

**Responsibilities**
- Receive and action claim files when a factor arises that may delay RTW or add costs to the claims that are not the responsibility of the employer
- To initiate requests for board Nurse Advisor/Medical Advisor intervention on RTW efforts as appropriate
- Take incoming phone calls from interested parties to either provide information or collect information for those parties
- Assess the costs attached to each claim, to best meet the needs of the client
- Prepare and compile information to be presented for entitlement issues (eg: modified duties refusal)
- Take the necessary action to ensure that entitlement issues are appealed to the appropriate appeal body as required and within required timeframes
- Manage new and contentious claims until all contentious issues have been resolved
- Complete a forensic review of high-cost claims for new clients and take necessary action in order to facilitate cost recovery
- To participate in Return to Work Meetings between our clients and WCB/WSBC/WSIB as required
- To initiate requests for cost relief on our client’s behalf and take the appropriate action
- Field inbound and outbound calls to clients, injured workers, physicians or other parties to gather information to assist in ensuring a safe Return-to-Work (RTW)
- Communicate in a consistent and timely manner with the employer and worker
- Arrange and schedule medical assessments, diagnostics, and surgeries as required for WCB/WSBC/WSIB and STD under the support of the treating physician
- Ensure all documents such as RTW plans, and medical assessments are collected, assessed and actioned
- Continually confirm status of worker, to ensure the RTW is successful
- Make decisions on the next course of action by analyzing medical assessments and client/worker information gathered
- Coordinate with co-workers to ensure accurate and imperative information is reviewed, requested and collected for each claim
- Inform client (by phone, when possible) of outcomes and updates
- Prepare scheduled reports for our clients to provide them with an update on the work being undertaken on their behalf
- Participate in client visits and conference calls as required
- Manage customized software database notes on case files by ensuring accuracy and inclusiveness
- Maintain database by updating information and closing case files once all claims have been addressed and advise all the appropriate parties involved

**Operational Knowledge**
- Comprehension of contentious claims and internal policies, procedures and requirements of WCB/WSBC/WSIB
- Understanding of formal business writing and compilation of documentation
- Understanding of medical terminology

**Skills/Abilities**
- Proven time management, prioritization and attention to detail skills
- Demonstrated ability to communicate actively and comfortably in using negotiation, dispute resolution, and problem sensitivity techniques
- Comfortable working independently and making decisions with confidence
- Ability to conduct research on the internet for medical terminology, medical assessment results, and/or for determining probable medical requirements
- Strong analytical abilities

**Job Types**: Full-time, Permanent

**Salary**: $40,000.00-$70,000.00 per year

**Benefits**:

- Casual dress
- Company events
- Dental care
- Employee assistance program
- Extended health care
- Flexible schedule
- On-site parking
- Paid time off
- RRSP match
- Tuition reimbursement
- Vision care
- Wellness program

Flexible Language Requirement:

- French not required

Schedule:

- 8 hour shift
- Day shift
- Monday to Friday

**Experience**:

- Case Management: 3 years (preferred)
- Workers' Compensation Board Knowledge: 3 years (preferred