Reporting to the Manager, Group Life and Disability Claims, the incumbent is responsible for processing short and long-term disability claims in order to determine if the participant is eligible for disability benefits while relying on medical reports deemed necessary as well as related policies and procedures. The case manager must develop a case management plan for every claim.
• Assess disability claims and determine eligibility for benefits via telephone interview while into consideration medical information and contractual provisions, as well as pursuing additional information to make a sound decision
• Conduct detailed telephone interviews to obtain the pertinent medical and non-medical information which has not already been obtained
• Develop and execute a case management plan
• Assess and identify the non medical factors and the functional limitations which are likely to influence the duration of disability and to facilitate the return to work in collaboration with a rehabilitation team.
• Determine the gradual return to work plan in collaboration with the attending physician, participant, and policyholder, as needed
• Communicate with policy holders, participants, health professionals, other services providers as well as various level of government in writing, by email, telephone, and fax. The Case Manager must also manage difficult calls with dissatisfied and potentially irate callers as a result of a decision to deny benefits
• Maintain the participant’s file in the system
• Commit to providing a high level of service
• Actively and proactively manage disability claims and using all sources available including IME’s and other resources available.
• Attends meetings with clients and suppliers
• Provides assistance with special projects
Qualifications
• Post Secondary education (health or medical related field is an asset) and a minimum of 2 years of related experience
• Excellent communication skills
• Well organized individual with strong analytical skills, excellent problem solving ability, and ability to work with minimal supervision
• Positive attitude, the ability to work well in a fast paced and demanding work environment
• Ability to work with multiple deadlines
• Adaptability and flexibility are necessary in this role
• Knowledge of occupational health and safety and medical terminology
• Customer Service oriented
• Ability to work in a multifunctional team environment
• LOMA and NIDMAR courses are an asset
iA Financial Group is committed to fostering a workplace that promotes diversity and inclusion. We can provide accommodation in our recruitment and selection processes to applicants with disabilities where required. Please contact me and I will work with you to meet your needs.
TOR2018
