Group Short Term Disability Claims Specialist
4 days ago
Work Arrangements: You will work from your home office 100% of the time. You may be required to be in-person at our office in Waterloo, ON or another assigned location within the Waterloo Region, on an as needed basis. Sales related roles may be required to travel based on the assignment.What you'll do:
Analyze medical, functional, employment and contractual information to make timely and accurate decisions on STD claims
Continually manage open STD claims using proficient problem solving and analytical skills and creating opportunities for timely resolution of the claim
Calculate benefits payable and make any adjustments as required throughout the course of the STD claims. (i.e., offset for CPP Disability Benefits and calculating overpayments, etc.)
Identify and implement cost effective case management tools to assist disabled employees (e.g., Rehabilitation Intervention, Functional Abilities Evaluations, Independent Medical Examinations, Medical Consultant Referrals)
Provide superior written and verbal customer service with accuracy and maintain well-documented, clear, and concise files
Frequently communicate with plan sponsors, plan members, advisors, Group Marketing Managers, medical professionals, legal professionals
Actively participate in client meetings
Professionally communicate with and show empathy to our clients over the phone and email (many are going through extremely difficult periods of their lives and communications may be emotionally charged)
Utilize key problem-solving skills to make tough decisions on claims, clearly communicating these decisions with the client in a way that is easy to understand
Showcase conflict resolution skills to de-escalate situations with unsatisfied clients
What you'll bring:
Proficient English, spoken and written, is required
2+ years' STD and/or LTD claims management experience is preferred
University degree or College Diploma preferred in health-related field (i.e. nursing, occupational therapy, kinesiology, psychology, social services etc.) or experience adjudicating disability claims
Thorough knowledge of insurance operations
Passion for problem-solving and thorough knowledge of insurance operations
Complex knowledge of various group contracts would be helpful
Computer literacy skills
Effective negotiating and conflict management skills
Excellent interpersonal and strong customer service skills
Mathematical & analytical skills
Demonstrated conflict management and professional de-escalation skills
Deep-rooted personal boundaries and time management, with the ability to balance various priorities coming in at once
Ability to break down difficult to understand concepts/decisions and explain in a way that is easy to understand for the client
Proven ability to succeed in a dynamic environment with changing priorities
What's in it for you:
Career Growth: Regular learning sessions and development opportunities
Total Rewards: Incentive pay, annual salary reviews, employer-paid benefits and pension matching
Time Away: Competitive vacation plus one paid volunteer day each year
Flexibility: Healthy work-life balance with employee wellness always top of mind, complemented by a "dress for your day" approach
At Equitable, we're committed to fair pay and an inclusive, accessible hiring experience. If you need accommodations or alternative formats at any stage, just reach out to us at We're happy to help.
Your base pay will be based on your skills, qualifications, experience and education. In addition to your salary, this role is eligible for a discretionary annual incentive award tied to business performance, plus a wide range of competitive benefits.
If you're selected to move forward, our Talent Acquisition team will walk you through all the details of our total rewards program, so you know exactly what's included. Reports To: Manager, Life STD LTD ClaimsDepartment: GroupTerm: Permanent Full-TimeLocation: Manitoba
How do I apply?
Select Apply Now at the bottom of the page and apply to the role through our careersite.
Complete your PLUM profile HERE and complete the Plum Discovery Survey. (Please note that priority will be given to applicants who complete the survey)
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