Bilingual STD / LTD Claims Adjudicator

STD/LTD Claims Adjudicator – Bilingual

Intermediate ($60k – $65) and Senior Roles Available ($70,000 +)

Comma Recruitment are looking for intermediate and senior Bilingual Disability Claim Adjudicators, you will review, assess and processes claims for applicable benefits using the technical knowledge obtained from the policies, procedural manuals, and industry and government communications.

Working in a team environment you will utilize your strong verbal and written communication skills when interacting with clients, claimants, and all relevant stakeholders.  The incumbent must be able to work independently with little supervision, possess the ability to distinguish priorities and adapt well to change.  The individual must work well under pressure and maintain production requirements.

Responsibilities include:

• Processes and manages all Weekly Income Claims paid directly, establishing eligibility, calculation of earnings and benefit levels, along with obtaining the necessary medical evidence.
• Ensures all necessary documentation is provided to the insurance carrier in order for them to process any claims submitted to them for adjudication.
• Ensures all claims are processed in date order, by automatically assisting other examiners in the processing of their assigned plan(s) when their own client base in good order.
• Maintains daily production requirements as determined by the Manager.
• Liaises in a professional manner with insurance agencies, doctors, trustees, members, management, lawyers and all other stakeholders, ensuring that only allowable information is released to recognized recipients and that all information is released in writing.
• Responsible for bilingual communication both oral and written. This includes French to English translation.
• Keeps abreast of industry and government requirements.
• Maintains confidentiality over client and corporate records and medical claims information.
• Operates priority claims payment database and is able to perform manual calculations as required.
• Keeps the Manager aware of problems or areas of concern that require special attention.

QUALIFICATIONS

1. Minimum one years related STD / LTD experience. Three years experience for senior candidates
2. Must have experience adjudicating complex disability claims cases, from a group insurance environment
3. Must possess excellent customer service skills, be team oriented and cooperative with co-workers, consultants and departments
4. Bilingual fluency is required (English/French)
5. Excellent analytical and letter writing skills, with attention to detail and accuracy
6. Ability to prioritize, multi-task and adapt well to change in a busy office environment
7. Ability to work well under pressure, meet deadlines and adhere to departmental standards.
8. As a self-directed individual, demonstrated good judgment with the ability to initiate and accomplish tasks expediently and with minimum supervision.
9. Possesses current knowledge and keeps abreast of industry and government requirements

Please forward resume to [email protected]