Medical Adjudicator - Nouveau-Brunswick, Canada - WorkSafeNB

Description

The team at WorkSafeNB is passionate about promoting health and safety in New Brunswick workplaces.

However, injuries do occur, and when they do, we are committed to providing caring recovery and return to work services, benefits, and compensation to injured workers and their families.

we lead and listen with empathy and embrace diversity, inclusion and belonging. WorkSafeNB is looking to hire permanent and term contract positions for Claim Adjudicators.

The normal hours of work for employees in the bargaining unit shall be thirty-five hours per 5-day workweek, Monday to Friday, between 8:00 a.m.

Reporting to the Manager, Adjudication Services, you will provide superior client service by rendering quality decisions in a timely fashion on claim entitlement and providing timely access to care for workers.

This includes medical aid and loss of earnings entitlement.

To protect the integrity of the system, you will make decisions in compliance with Workers' Compensation Act or any other relevant legislations, and WorkSafeNB policies, directives, and standard operating procedures.

Providing quality and timely decisions on claim entitlement in keeping with established service standards by claim type for all new claims, reconsiderations and recurrences while maintaining compliance with legislation, policies and procedures.

• anchored into legislation and policies.
• Gathering and requesting any information and evidence required to complete and weigh it, using administrative justice principles, to ensure quality and timely adjudication decisions are made in accordance with legislation, policies, and standard operating procedures.
• Evaluating and determining if new incoming information is material and substantial and a claim decision should be reconsidered or if a new decision is required.
• Utilizing disability duration guidelines to educate and create expectation regarding stay at work and return to work options with workers, employers, and service providers. Initiating, supporting, authorizing, and setting-up the medical rehabilitation plan (including return to work plans) in accordance with legislation, policies, and standard operating procedures.
• Identifying issues impacting the claim, recovery, and stay/return to work and coordinate appropriate referrals when indicated.

A completed University Degree in business, law, education, health care, social sciences, kinesiology, or a related field.

• Must have a minimum two years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience such as, but not limited to:

o Making adjudicative decisions or entitlement decisions or insurance claims decisions based on a defined set of criteria (i.e., policies, procedures, legislation, etc.)
o Applying law and/or policy to make determinations based on a defined set of criteria (i.e., policies, procedures, legislation, etc.)
o Writing high-level decision documents for presentations at quasi-judicial hearings

o Working in a health care field with experience in having gained knowledge of medical terminology/issues and an ability to interpret medical reports.

• Ability to communicate effectively complex and difficult concepts in a clear and concise manner, both verbally and in writing.
• Ability to objectively review information and apply independent reasoning for quality and timely decision-making in a fast-paced, high-volume work environment. Ability to obtain, assess and evaluate information to support claims decisions. Ability to interpret and apply provisions, policies, procedures, and legislation. Understanding of the Workers' Compensation Act, Firefighters Act and any other relevant legislation and policies.
• The following equivalent combination of education, training and experience may be considered:
• A completed two (2) year post-secondary education diploma in business, law, health care or social science-related fields, or a related field with four (4) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.
• Or a completed one (1) year paralegal post-secondary education diploma with five (5) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.

Written and spoken competency in English and French are required for these positions.

This competition will also be used to establish an inventory of qualified candidates to fill permanent and casual, bilingual full-time Adjudicator positions.

Hourly rate:
$34.71, as per the current collective agreement - Canadian Union of Public Employees Local 1866. Your primary workspace will be from your in-home office, with the occasional expectation of in person meetings, for that reason, working from outside the province or country is not permissible.

If you are interested in an exciting and rewarding opportunity with WorkSafeNB, please apply online at by May 22, 2024.

For more information about WorkSafeNB, or this and other employment opportunities, please visit our website at worksafenb.