Claim Manager - Kingston, Canada - THE EMPIRE LIFE INS. CO

THE EMPIRE LIFE INS. CO

Verified Company

Kingston, Canada

1 week ago

Posted by:

Sophia Lee

beBee Recruiter

Description

Summary
The Claim Manager applies disability management best practices to effectively manage the payment, expenses and risk associated with weekly indemnity and longterm disability claims within approved authority limits.

The incumbent is guided by defined procedural constraints, and works under the moderate supervision of the Manager, Life and Disability Claim Management.

Responsibilities Investigate, evaluate and determine eligibility for initial and ongoing payment claims based on medical information, job requirements, nonmedical factors, contract terms and department/industry protocols within established service standards Manage active claims duration by utilizing best practices Interview claimants and employers through telephone interviews Ensure accurate and timely documentation of all communication with customers Formulate and implement a detailed case management plan on each file with a focus on a timely, sustainable and safe return to work; interact with and appropriately challenge treating physicians and employers; make referrals for independent medical assessments and to alternate insurance organizations (federal, provincial and private insurers) Collaborate with inhouse return to work facilitators to design and monitor return to work programs Collaborate with team members to exchange ideas, gather information and offer solutions on claims Based on department standards, ensure proactive communication with our customers regarding claim status and developments Accountable for positive file resolution and appropriate outcomes

Skills / Knowledge / Education Completion of a university degree in anatomy, biology, kinesiology, life sciences or psychology 3+ years work experience in disability claim management Knowledge of medical terminology and Disability Management best practices/protocols Knowledge of relevant provincial employment legislation and legal requirements Bilingual (English/French) is an asset LOMA 280, 290, HIAA, CEBS GBA are assets Welldeveloped verbal/written communication and interpersonal skills Welldeveloped customer relations skills Ability to work independently and as a collaborative team member Ability to prioritize and balance multiple tasks Ability to research, analyze, evaluate, negotiate, make decisions and resolve problems
Working Conditions Office environment Prolonged periods of concentration and attention to detail Prolonged periods of sitting while using a computer and/or telephone Frequent interruptions with tight timelines The incumbent may be required to work extended hours and/or overtime Frequent contact with emotionally distraught and upset/angry people Interactions:

Empire management and employees on a local and national basis

Employers, employees and clients who purchase Company products Third party providers including health care provider offices, medical professionals, legal firm representatives, security and surveillance companies Industry associations and government agencies Other insurance companies and financial institutions