Group Long Term Disability Claims Specialist

Reports to

Manager, Life & Disability Claims

Location

Waterloo, Ontario

Job Status

Permanent, Full-Time

Accountabilities:

• Analyze medical, functional, employment and contractual information in order to make timely and accurate decisions on STD and LTD claims
• Continually manage open STD and LTD claims using proficient problem solving and analytical skills and creating opportunities for timely resolution of the claim.
• Calculate benefits payable and make adjustments as required throughout the course of the STD and LTD claims. (i.e. offset for CPP Disability Benefits and calculating overpayments, etc.)
• Identify and implement cost effective case management tools to assist disabled employees (e.g. Rehabilitation Intervention, Functional Abilities Evaluations, Independent Medical Examinations, Medical Consultant Referrals)
• Provide superior written and verbal customer service with accuracy and maintain well-documented, clear and concise files
• Frequently communicate with plan sponsors, plan members, advisors, Group Marketing Managers, medical professionals, legal professionals
• Actively participate in client meetings
  
  

Qualifications:

• University degree or College Diploma preferred in health related field (i.e. nursing, occupational therapy, kinesiology, etc.) or experience adjudicating disability claims
• Bilingual in French and English, both spoken and written is an asset
• LTD or STD claims management experience preferred
• Thorough knowledge of insurance operations
• Proficient problem solving skills and thorough knowledge of insurance operations
• Complex knowledge of various group contracts helpful
• Computer literacy skills
• Effective negotiating and conflict management skills
• Excellent interpersonal and strong customer service skills
• Mathematical & analytical skills