|Job Ref:||f66246ab4||Employer:||Direct Solutions - Canada||Country:||Canada||County/State:||Ontario||City:||Kingston||Address:||Post Date:||04/10/2016 23:11|
We are currently recruiting a Bilingual (French and English) Senior Claims Manager for our client in Kingston Ontario Location: Kingston Ontario Position: Senior Claim Manager Duration: Full Time Permanent Salary: Industry Competitive Benefits: Yes Overview:Supports Divisional profitability results and mitigates negative reputation and litigation risk through the application of effective claims management protocols and procedures focusing on a timely, sustainable and safe return to work; ensuring appropriate cost/benefit analysis relative to reserves heldDevelops and implements a detailed case management plan on complex claims and claims with a high reserve; with a key focus on managing complex people dynamics and assimilating disparate information to reach a sound decisionSupports the divisions customer service delivery promise through prompt decision making and pro-active customer communication and service by providing education, support and ongoing relationship management to customers and producers Responsibilities Investigate, evaluate and determine eligibility for initial and ongoing payment of weekly indemnity claims, long-term disability claims and associated life waiver claims based on medical information, job requirements, non-medical factors, contract terms and department/industry protocols within established service standardsManage active claims duration utilizing Best PracticesMaintain extensive contact on the telephone including interviews with claimants and employersFormulate and implement a detailed case management plan on each file with a focus on a timely, sustainable and safe return to work; interact with and appropriately challenge treating physicians and employers; make referrals for independent medical assessments and to alternate insurance organizations (federal, provincial and private insurers)Review claim files for rehabilitation potential and collaborate with external rehabilitation vendors and consultants to design and monitor return to work programs for complex claimsWork closely with customers and producers to negotiate and provide education on disability management best practices and recommended approaches on challenging cases or developments including structured fact-finding of customer needsBased on department standards, ensure proactive communication with our customers regarding claim status and developmentsAccountable for positive file resolution and appropriate outcomes Requirements 5+ years work experience in disability claim management in a specialist roleComprehensive knowledge of medical terminology and Disability Management best practices/protocolsSolid knowledge of relevant provincial employment legislation and legal requirementsKnowledge of word processing, spreadsheet, email, internet and database softwareExtensive knowledge of insurance industryBilingualism (English/French)GBA or CEBS designation Education / Professional CoursesCompletion of a university degree in anatomy, biology, kinesiology, life sciences, or psychologyInsurance related courses is an asset Key SkillsAbility to apply policy terms and adjudication guidelines & modify actions to fit business needsWell-developed verbal/written communication and interpersonal skillsWell-developed customer relations skills including problem-resolution, negotiation and relationship building Please state your salary expectations. Thank you I
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