Analyste de Dossier d'Invalidité / Disability Adjudicator

Analyste de Dossier d’Invalidité / Disability Adjudicator

Bilingualism (French, English, both oral and written) is required to answer calls from English and French speaking clients across Canada and worldwide.
Excellent communication skills
Ability to handle calls of a sensitive or emotionally charged nature
Well organized individual with strong analytical skills, excellent problem solving ability and can work with a minimum of supervision
Must have a positive attitude, a commitment to quality service and be able to cope with the stress inherent in the nature of disability claims assessing, including high work volumes
Good keyboarding skills and able to work in a PC environment
Attention to detail is important due to the complexity of claims situations and contractual considerations
Adaptability and flexibility are key to success in this role
Strong team player, with a high interest in working in a cross-functional team environment
Strong decision making
Medical experience obtained through claims assessing, underwriting, nursing and health profession
Knowledge of disability products and administration

Assess new short term disability (STD) claims for eligibility (coverage) and benefit entitlement by reviewing contractual, medical and occupational information
Manage STD claims during acute period of absence. At this point, claims are transitioned to a Disability Case Managers. Ensure a smooth transition to the Disability Case Managers as required
Develop and maintain appropriate action plans directed toward ethically influencing early and timely recovery, where appropriate
Communicate in a clear, effective and professional manner with plan members, plan sponsors, in order to obtain information and to convey claim status, action plans and decisions verbally and in writing, taking into account Privacy and Confidentiality and using language and tone that is geared to needs of audience
Communicates with lawyers, physicians and other departments through electronic mail, telephone, written correspondence and occasionally in person
Ensure work is completed accurately and in compliance with practice guidelines
Adhere to process audit control reports
Manage claims, using applicable caseload management tools, prioritizing work items in order to meet client service standards
Takes responsibility for own personal job satisfaction and continuous development
Contribute to and foster a positive working environment. This ranges from identifying opportunities to improve processes and customer service through to providing support to team members, where possible, to ensure service standards are met

No preferred qualifications provided.