Disability Adjudicator

3 weeks ago


Montreal, Canada Sun Life Full time

Job Description

:

The Disability Adjudicator (DA) is a member of a team responsible for assessing and managing claims to resolution. This includes determining if plan members are entitled to receive benefit payments and developing appropriate actions plans for each claim. The actions of our Disability Case Managers (DCM) are aligned with our outcome focused case management methodology, our philosophy that work is healthy and our mission to assist Plan Sponsors in promoting the health and wellbeing of their Plan Members and providing them with financial peace of mind for their families. As Health Promoters Abilities Case apply a fair and consistent approach to claims management. Plan Members are engaged through open and respectful communication that considers the medical, social and personal dimensions of their claim. Disability Adjudicator also communicate regularly with our Plan Sponsors to ensure that they know what to expect in terms of recovery time lines for their members. 

What will you do?

Assess new short term disability (STD) claims for eligibility (coverage) and benefit entitlement by reviewing contractual, medical and occupational information

Manage STD claims during acute period of absence. At this point, claims are transitioned to a Disability Case Managers. Ensure a smooth transition to the Disability Case Managers as required 

Develop and maintain appropriate action plans directed toward ethically influencing early and timely recovery, where appropriate.

Communicate in a clear, effective and professional manner with plan members, plan sponsors, in order to obtain information and to convey claim status, action plans and decisions verbally and in writing, taking into account Privacy and Confidentiality and using language and tone that is geared to needs of audience.

Communicates with lawyers, physicians and other departments through electronic mail, telephone, written correspondence and occasionally in person.

Ensure work is completed accurately and in compliance with practice guidelines. 

Adhere to process audit control reports.

Required competencies: 

Excellent communication skills

Ability to handle calls of a sensitive or emotionally charged nature

Well organized individual with strong analytical skills, excellent problem solving ability and can work with a minimum of supervision

Must have a positive attitude, a commitment to quality service and be able to cope with the stress inherent in the nature of disability claims assessing, including high work volumes

Good keyboarding skills and able to work in a PC environment

Strong team player, with a high interest in working in a cross-functional team environment

Strong decision making

Medical experience obtained through claims assessing, underwriting, nursing and health profession

Knowledge of disability products and administration 

Bilingualism (French, English, both oral and written) is required for the frequent interactions with English and French-speaking colleagues or internal partners across Canada and worldwide.

What’s in it for you?

We’re proud to be recognized as a company with a 2023 Most Trusted Executive team by Great Place to Work® Canada

Access to short-term assignments or ‘Gigs’ across the organization, to help you develop new skills and connections.

A collaborative and interactive team environment

 Charitable giving through our You Give, We Give program lets you give back to your community – and in many cases, we’ll match your contributions.

Care Days available for self-care or care of others (i.e., family or others you may support) and Sick Days to support your well-being.



  • Montreal, Canada Duale Hochschule Baden-Württemberg Mannheim Full time

    Manage disability claims (STD/LTD) for our clients and help their employees return to work in a safe, timely way. You’re exceptionally skilled at fact gathering, reviewing objective medical information and analyzing cases with proven return to wellness strategies. You have at least two years of disability management experience, including short-term and...


  • Montreal, Canada Duale Hochschule Baden-Württemberg Mannheim Full time

    Manage disability claims (STD/LTD) for our clients and help their employees return to work in a safe, timely way. You’re exceptionally skilled at fact gathering, reviewing objective medical information and analyzing cases with proven return to wellness strategies. You have at least two years of disability management experience, including short-term and...


  • Montreal, Canada Duale Hochschule Baden-Württemberg Mannheim Full time

    Manage disability claims (STD/LTD) for our clients and help their employees return to work in a safe, timely way. You’re exceptionally skilled at fact gathering, reviewing objective medical information and analyzing cases with proven return to wellness strategies. You have at least two years of disability management experience, including short-term and...


  • Montreal, Canada Duale Hochschule Baden-Württemberg Mannheim Full time

    Manage disability claims (STD/LTD) for our clients and help their employees return to work in a safe, timely way. You’re exceptionally skilled at fact gathering, reviewing objective medical information and analyzing cases with proven return to wellness strategies. You have at least two years of disability management experience, including short-term and...


  • Montreal, Canada Duale Hochschule Baden-Württemberg Mannheim Full time

    Manage disability claims (STD/LTD) for our clients and help their employees return to work in a safe, timely way. You’re exceptionally skilled at fact gathering, reviewing objective medical information and analyzing cases with proven return to wellness strategies. You have at least two years of disability management experience, including short-term and...


  • Montreal, Canada Desjardins Full time

    At Desjardins Insurance, our mission is to support our members, clients and partners in the event of a disability claim by providing the support and assistance they need to ensure a lasting return to health, while managing the cost of claims. To achieve this mission, we want to simplify and optimize the way we do business in order to modernize and ensure...


  • Montreal, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...


  • Montreal, Quebec, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...


  • Montreal, Quebec, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...


  • Montreal, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...


  • Montreal, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...


  • Montreal, Canada The Cigna Group Full time

    Bilingual Customer Service Representative - Express Scripts CanadaExpress Scripts Canada is a Cigna company Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated...

  • Bilingual CSR

    3 weeks ago


    Montreal, Canada The Cigna Group Full time

    Le personnel du Centre d’appels à l’intention des fournisseurs agit à titre d’intermédiaire entre les fournisseurs et Express Scripts Canada en ce qui concerne les demandes quotidiennes relatives au traitement des demandes de règlement. Le représentant du Centre d’appels doit refléter l’engagement d’Express Scripts Canada en matière...

  • Bilingual CSR

    2 weeks ago


    Montreal, Canada The Cigna Group Full time

    Le personnel du Centre d’appels à l’intention des fournisseurs agit à titre d’intermédiaire entre les fournisseurs et Express Scripts Canada en ce qui concerne les demandes quotidiennes relatives au traitement des demandes de règlement. Le représentant du Centre d’appels doit refléter l’engagement d’Express Scripts Canada en matière...


  • Montreal, Canada The Cigna Group Full time

    Le personnel du Centre d’appels à l’intention des fournisseurs agit à titre d’intermédiaire entre les fournisseurs et Express Scripts Canada en ce qui concerne les demandes quotidiennes relatives au traitement des demandes de règlement. Le représentant du Centre d’appels doit refléter l’engagement d’Express...


  • Montreal, Canada Bell Canada Full time

    Req Id: 418061At Bell, we do more than build world-class networks, develop innovative services and create original multiplatform media content – we advance how Canadians connect with each other and the world.If you're ready to bring game-changing ideas to life and join a community that values, professional growth and employee wellness, we want you on the...


  • Montreal, Canada TEKsystems Full time

    Our client is looking for a Bilingual Intake Specialist to join their team on a contract basis. As an intake specialist, you will be answering phone calls, emails and chat messages from our clients that are traveling outside of Canada. You will be the first point of contact for medical and non-medical assistance before assigning the case to a Case...


  • Montreal, Canada Global Payments Full time

    Every day, Global Payments makes it possible for millions of people to move money between buyers and sellers using our payments solutions for credit, debit, prepaid and merchant services. Our worldwide team helps over 3 million companies, more than 1,300 financial institutions and over 600 million cardholders grow with confidence and achieve amazing...


  • Montreal, Canada Global Payments Full time

    Every day, Global Payments makes it possible for millions of people to move money between buyers and sellers using our payments solutions for credit, debit, prepaid and merchant services. Our worldwide team helps over 3 million companies, more than 1,300 financial institutions and over 600 million cardholders grow with confidence and achieve amazing...


  • Montreal, Canada Montreal, QC, Canada Full time

    Mortgage Underwriter, Third Party Residential Underwriting Thursday, May 16, 2024 First National is proud to be an equal opportunity employer and is committed to diversity and inclusion regardless of race, color, religion, national origin, age, gender identity, physical or mental disability, sexual orientation or any other category protected by law. ...