Disability Claims Specialist

For over 75 years, Medavie Blue Cross has been a leading health and wellness partner for individuals, employers and governments across Canada. As a not-for-profit organization, we proudly invest in communities to help address some of Canada’s most pressing health care challenges. We are one of Canada's Most Admired Corporate Cultures, one of Canada’s Top 100 Employers, Canada’s Life & Health Insurer of the Year for 2021 and an Imagine Canada Caring Company.

Our 2,400 professionals work across six provinces, united by our shared values of being caring, accountable, responsible, innovative and community-minded. We’re committed to ensuring our employees thrive in our award-winning, collaborative culture focused on ensuring health, wellness, and personal and professional growth through a variety of programs and support across our organization.

Together with Medavie Health Services, we are part of Medavie — a national health solutions partner with over 7,200 employees. Our mission is to improve the wellbeing of Canadians.

**Job Title**:

- Disability Claims Specialist**Department**:

- Medavie and Underwriting**Competition**:

- 85340**Internal/External**:

- Both**Employment Type**:

- Full Time Permanent**Location**:

- Ontario, Quebec, Nova Scotia, New Brunswick, PEI - Full time Remote available.**Salary**:

- Competitive Compensation**Reports To**:

- Team Leader As a
** Bilingual Disability Claims Specialist **you will be working and collaborating with a team of talented professionals in a fast paced, high-energy work environment to ensure service level standards are met by managing a block of short or long-term disability cases. Disability Claims Specialists are responsible for every part of the disability claim process, from the initial decision, to building the right case management plan which includes but is not limited to: identifying the supports needed for each case, monitoring treatment and the achievement of the plan and working with the claimant, employer and providers involved in the case. Effective communication and organizational skills are an essential requirement for this role to help ensure all key milestones are met for each case.

**Key Responsibilities**:

- Disability claim adjudication; reviewing eligibility of claimant, assessing total disability through the evaluation of medical information, telephone interviews etc.
- Active case management of files; provide ongoing and regular communication with all stakeholders of claim, assess use of claim tools (rehab, IME etc.), review and request ongoing medical as needed, provide ongoing assessment of key dates within the lifecycle of the claim (COD etc.) and ensuring case management plans are updated regularly.
- Accountability and responsibility to ensure that the management of required tasks within the assigned case load meets all service level standards.
- Render decisions on a timely basis and effectively communicate these decisions, at times potentially difficult decisions and manage escalations with employers and claimants.
- Build effective relationships with key stakeholders and claimants to support recovery and return to work.
- Effective and consistent use of an electronic case management system.

**Qualifications**:

- **Education**: Post-secondary university or a college degree completed in the health sciences or a related field
- **Work Experience**:2 to 5 years equivalent experience in case management with another insurer or government agency, managing Short or Long Term Disability claims
- **Experience in claims systems developed by Finneos.**

**Other Qualifications & Assets**:

- Strong written and verbal communication skills to successfully partner and influence various stakeholders including the claimant, their treatment providers and physicians, the employer, group administrators, human resources, and lawyers.
- Excellent customer service and telephone skills and the ability to communicate complex and difficult information clearly with tact and sensitivity.
- A general understanding of the health care and insurance fields, health related terminology, concepts of accommodation and return to work.
- Motivation to learn, ability to multitask, excellent organizational skills.
- An understanding of contract wording and the ability to thoroughly review medical reports and other tools available (e.g., Independent Medical Exams, Function Capacity Exams, surveillance, medical consultant reviews) is an asset.

**Computer Skills**: Proficient keyboarding and technical aptitude in Microsoft Office. Experience working with an electronic case management system is an asset.

**Language**: In order to meet the needs of the English-speaking clientele, this position requires bilingualism ( English/French).

**#CBM1**

**Do you want to be a part of this team? Hear what some of our team members have to say**:

- “I didn’t have experience in this field when I first got hired, but I’ve been here for over two years now and th