Disability Claims Auditor

6 days ago

St Jacobs, Canada Orion Audit Ltd. Full time

**Disability Claims Auditor - Group Benefits**

Orion Audit Limited, an affiliate of Burke and Company, has been conducting Drug, Extended Health Care, Dental, and Disability Group benefits claims audits since 2005. We have quickly emerged as the industry leader and have a reputation for bringing strong governance and accountability to benefit plans across Canada.

We are seeking innovative and energetic individuals with impressive experience and a proven track record to join us and contribute to our standard of excellence in the area of Disability claims audit. This role requires a dedicated, detail-oriented individual who can work collaboratively in a team environment and be self-motivated to work independently as needed. The main working location is St. Jacobs, Ontario, with some travel to Vaughan.

**Responsibilities**
- Conduct high quality, detailed STD and LTD audits; evaluate adjudication processes, disability management, and adherence to insurance contracts/service agreements
- Identify opportunities and provide recommendations to improve the claims administrative processes with a focus on cost savings and risk management
- Communicate meaningful insights, recommendations, and observations for our clients through formal written reports and presentations
- Participate in the preparation and presentation:
1. of audit findings and recommendations to clients

2. consulting projects and quarterly/monthly client meetings

3. to generate new business opportunities

**Requirements**:

- Minimum three years of experience in Disability Case Management for Group Benefit plans at a TPA and/or insurance company
- Strong working medical knowledge and terminology applicable to disability and health claims
- Solid background and familiarity with industry best practices
- Results oriented; ability to balance multiple priorities
- Demonstrated strong written and verbal communication skills
- Comfortable speaking/presenting information in a group setting
- Ability to manage fluctuating and unpredictable workload
- Strong research, problem-solving, and decision-making skills
- Capable of learning quickly and an eagerness to take on new tasks

**Assets**
- Experience in the adjudication of Extended Health Care claims
- Clinical experience in the medical field
- Bilingualism (French/English)

**Job Type**
- Schedule: Permanent full-time in the St. Jacobs office with the option to work from home
- Temporary full-time work from home due to COVID
- Group Insurance Plan provides Life, Accident, Long Term Disability, Medical, and Dental Insurance coverage, an Employee Assistance Program, and Group Retirement Savings Plan
- Travel: 10% (estimated) - Travel is across Canada and to head office in Vaughan, Ontario
- Competitive compensation package based on experience

**Salary**: $50,000.00-$70,000.00 per year

**Benefits**:

- Dental care
- Disability insurance
- Employee assistance program
- Extended health care
- Life insurance
- On-site parking
- Paid time off
- RRSP match
- Vision care
- Work from home

Schedule:

- 8 hour shift
- Monday to Friday

COVID-19 considerations:
Temporary full-time work from home due to COVID.

Application question(s):

- Please provide a cover letter.

**Experience**:

- Disability case manager: 3 years (preferred)

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