Bilingual STD Claims Examiner

Bilingual Short Term Disability Examiner

Comma Recruitment are looking for a talented Bilingual STD Claims Examiner, reporting to the Manager Life and Disability and working closely with the Team Lead, the incumbent reviews, assesses 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, maintain production requirements and must be willing to work overtime as required.

The individual will ensure 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 is in good order and will liaise 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.

You will be required to process and manage Disability claims, establishing eligibility, calculation of earnings and benefit levels, along with obtaining the necessary medical evidence.

You will ensure all necessary documentation is provided to the insurance carrier in order for them to process any claims submitted to them for adjudication.

The successful candidate will maintain daily production requirements as determined by the Manager and keep the Manager aware of problems or areas of concern that require special attention. Confidentiality must be maintained over client and corporate records and medical claims information.

You will be required to operate a claims payment database as well as able to perform manual calculations. Following training period, a minimum of 95% accuracy is required.

Success in this role would be the mastery of the processes you touch on a day-to-day basis and your ability to keep abreast of industry and government requirements.

Qualifications

• Bilingual (French and English)
• Minimum two years related experience. Must have experience adjudicating complex disability claims cases, in a group insurance environment
• Experience adjudicating disability claims in a Unionized or Multi-employer background is an asset
• Must possess excellent customer service skills, be team oriented and cooperative with co-workers, consultants and departments
• Excellent analytical and letter writing skills, with attention to detail and accuracy
• Ability to prioritize, multi-task and adapt well to change in a busy office environment
• Ability to work well under pressure, meet deadlines and adhere to departmental standards.
• A self-directed individual who has demonstrated good judgment with the ability to initiate and accomplish tasks expediently and with minimum supervision
• Possesses current knowledge and keeps abreast of industry and government requirements.

Please forward resume to [email protected]