Disability Claims Case Specialist – 5 years experience

Disability Claims Case Specialist – Mississauga/Toronto

Comma Recruitment are looking for a Disability Claims Case Specialist, a ’go-to’ person for large and complex group claims.

Under the immediate authority of the Director, the incumbent acts as a resource person for managing disability cases, validates the strategies used by case managers, acts as a resource person for case managers in the daily management of cases affecting the assessment of decisions, the duration of the disability or the development of strategies with regard to disability, rehabilitation, or suitable claim file settlements.

• On a daily basis, validates strategies used by case managers in disability cases and when necessary, provides individual or group feedback to the team or management.
• Collaborates and participates in the preparation and follow-up meetings with policy holders.
• Identifies common trends related to managing disability and rehabilitation cases; with appropriate recommendations on resolution to directors.
• Collects data, analyzes, revises and makes recommendations in response to complaints received, including formal notices received directly from the insureds.
• Plans, coordinates and leads various best practices committees and discussions regarding cases.
• Approves contractual issues of all disability cases (change of definition, PTD)
• Works with the department on development projects and activities in order to verify standards established both internally and in the market.
• Updates and shares statistical data with the team.
• Identifies ongoing training needs among teams, develops and implements personalized development plans for claims case managers and follows the progression of recommendations.
• Fulfils all other responsibilities delegated by his or her Director.

QUALIFICATIONS:

• Bachelor’s degree or the equivalent in a discipline related to the health industry.
• Ideally 5+ years’ experience in the group insurance disability sector.
• Strong command of the English language, both spoken and written
• Excellent knowledge of group insurance administrative procedures and current disability management best practices.
• In-depth knowledge of medical terminology and understanding treatments and prognoses.
• Knowledge of provincial legislation.

Please forward a resume to [email protected]