Job Order Detail

Description

Employer Job Number: GO-00568921
Facility: 3sHealth
Job Description: The Claims Adjudicator is a member of the Claims Services team responsible for assessing and managing short and long-term disability claims to resolution. This includes determining if the claimants are eligible for benefit payments and developing appropriate action plans for each claim. The Adjudicator works in partnership with claimants, member organizations, unions, lawyers, physicians and rehabilitation consultants. The Claims Adjudicator makes timely decisions based on medical information vocational components, and plan policies, while effectively and proactively managing a caseload of ongoing claims.
Required Qualifications

Degree/Certification in Human Resources, Disability Management or Occupational Health and Safety is preferred
Experience in vocational rehabilitation, disability management or attendance support would be an asset
Experience

A minimum of 5 years' experience in insurance and/or disability claims adjudication, or an equivalent combination of education and experience.

Medical experience obtained through claims assessing, underwriting, nursing or a health profession is an asset.
Knowledge, Skills and Abilities

Ability to work independently and as a member of a multi-disciplinary team
Excellent written and verbal communication skills, and high attention to detail
Ability to establish and maintain effective interpersonal/consultative relationships including conflict resolution
Medical knowledge as well as demonstrated knowledge in aspects of human behaviour, counseling, interviewing, referral procedures and community resources.
Ability to identify root cause of issues and develop/recommend solutions.
Ability to manage time and set perso
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