For over 75 years, Medavie Blue Cross has been a leading health and wellness partner for individuals, employers and governments across Canada. As a not-for-profit organization, we proudly invest in communities to help address some of Canada's most pressing health care challenges. We are one of Canada's Most Admired Corporate Cultures, one of Canada's Top 100 Employers, Canada's Life & Health Insurer of the Year for 2021 and an Imagine Canada Caring Company.
Our 2,400 professionals work across six provinces, united by our shared values of being caring, accountable, responsible, innovative and community-minded. We're committed to ensuring our employees thrive in our award-winning, collaborative culture focused on ensuring health, wellness, and personal and professional growth through a variety of programs and support across our organization.
Together with Medavie Health Services, we are part of Medavie - a national health solutions partner with over 7,200 employees. Our mission is to improve the wellbeing of Canadians.
Job Title: Bilingual Disability Claims Specialist Department: Medavie and Underwriting Competition: 85340 Internal/External: Both Employment Type: Full Time Permanent Location: Ontario, Quebec, Nova Scotia, New Brunswick, PEI - Full time Remote available. Salary: Competitive Compensation Reports To: Team Leader
As a Bilingual Disability Claims Specialist you will be working and collaborating with a team of talented professionals in a fast paced, high-energy work environment to ensure service level standards are met by managing a block of short or long-term disability cases. Disability Claims Specialists are responsible for every part of the disability claim process, from the initial decision, to building the right case management plan which includes but is not limited to: identifying the supports needed for each case, monitoring treatment and the achievement of the plan and working with the claimant, employer and providers involved in the case. Effective communication and organizational skills are an essential requirement for this role to help ensure all key milestones are met for each case.
Key Responsibilities:

• Disability claim adjudication; reviewing eligibility of claimant, assessing total disability through the evaluation of medical information, telephone interviews etc.
• Active case management of files; provide ongoing and regular communication with all stakeholders of claim, assess use of claim tools (rehab, IME etc.), review and request ongoing medical as needed, provide ongoing assessment of key dates within the lifecycle of the claim (COD etc.) and ensuring case management plans are updated regularly.
• Accountability and responsibility to ensure that the management of required tasks within the assigned case load meets all service level standards.
• Render decisions on a timely basis and effectively communicate these decisions, at times potentially difficult decisions and manage escalations with employers and claimants.
• Build effective relationships with key stakeholders and claimants to support recovery and return to work.
• Effective and consistent use of an electronic case management system.

Qualifications:

• Education: Post-secondary university or a college degree completed in the health sciences or a related field
• Work Experience: 2 to 5 years equivalent experience in case management with another insurer or government agency, managing Short or Long Term Disability claims
• Experience in claims systems developed by Finneos.

Other Qualifications & Assets:

• Strong written and verbal communication skills to successfully partner and influence various stakeholders including the claimant, their treatment providers and physicians, the employer, group administrators, human resources, and lawyers.
• Excellent customer service and telephone skills and the ability to communicate complex and difficult information clearly with tact and sensitivity.
• A general understanding of the health care and insurance fields, health related terminology, concepts of accommodation and return to work.
• Motivation to learn, ability to multitask, excellent organizational skills.
• An understanding of contract wording and the ability to thoroughly review medical reports and other tools available (e.g., Independent Medical Exams, Function Capacity Exams, surveillance, medical consultant reviews) is an asset.

Computer Skills: Proficient keyboarding and technical aptitude in Microsoft Office. Experience working with an electronic case management system is an asset.
Language: In order to meet the needs of the English-speaking clientele, this position requires bilingualism ( English/French).
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Do you want to be a part of this team? Hear what some of our team members have to say:
"I didn't have experience in this field when I first got hired, but I've been here for over two years now and there has been a great level of support from colleagues and management that's helped me build my confidence and skills for this job. You're always learning something new and there is so much opportunity for growth!" - Lily, Disability Claims Consultant
"You immediately feel like part of a family, not a business, when you join MBC. The people are what make this an amazing place to work" - Kim, Manager, Disability Case Management
"This is one of the most rewarding places that I have worked in. The job is very flexible by allowing you to work from home. Most importantly, the team is fantastic, so you look forward to going to work every day." - Joana, Senior Disability Claims Consultant
"This company really values their employees; the disability team is supportive and there is a good work-life balance. Working for Medavie Blue Cross is very rewarding." - Annie, Disability Claims Consultant
"Since the day I started at MBC, I was met with caring, passionate, and supportive colleagues and leaders that never hesitate to lend a helping hand when needed. MBC truly values their people and encourages both personal and professional growth and opportunities." - Abegail, Disability Claims Specialist
"Working for a not for profit organization allows us to truly live some of our values, caring and community-minded, on a daily basis. There is a warm, family feel within our teams, despite our current virtual environment" - Erin, Manager, Health & Disability Management
We are an Equal Opportunity Employer.
Medavie Blue Cross strives to foster a culture where everyone is enabled to achieve their full potential -a culture of diversity, equity and inclusion (DEI) where we live our values every day in the way we treat each other, our members and the communities we serve. Accessibility is a top priority.
For applicants with disabilities, we provide accommodations throughout the recruitment, selection and/or assessment process. If selected to participate in the recruitment, selection and/or assessment process, please inform Medavie Blue Cross Human Resources staff of the nature of any accommodation(s) that you may require in respect of any materials or processes used to ensure your equal participation. All personal information is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act.
We would like to thank all candidates for expressing interest. Please note only those selected for interviews will be contacted.
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