- Adjudicate Short Term Disability and Long Term Disability claims.
- Ensure proper application of rules and regulations as outlined in the Group Policy and in accordance with the Canadian Life and Health Association (CLHIA) guidelines.
- Plan, implement and evaluate sound case management principles.
- Responsible for the issuance of correct benefit payment.
- Responsible for professional and accurate verbal and written communication with all stakeholders.
- Manage assigned portfolio and become subject matter expert on assigned groups.
- Communicate with other departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, Accounting, etc. to provide and exchange information regarding claims activities, eligibility and financial transactions.
- Experience and/or education related to disability claims management is preferred.
- Knowledge of the insurance benefit industry is considered an asset.
- Requires analytical skills, detail orientation and organizational skills.
- Demonstrated excellence in the decision-making process especially when under pressure.
- Strong team-player skills and cooperative attitude.
- Excellent written and verbal communication skills.
- Requires strength in the areas of flexibility, innovation and independence.
- Must be able to deal effectively with the public, peers, and co-workers.
- Knowledge of and experience with Microsoft Word and Excel will be an asset.
- Enrollment in LOMA or other industry related courses would be an asset.
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