Job Description

At Desjardins, we believe in equity, diversity and inclusion. We\'re committed to welcoming, respecting and valuing people for who they are as individuals, learning from their differences, embracing their uniqueness, and providing a positive workplace for all. At Desjardins, we have zero tolerance for discrimination of any kind. We believe our teams should reflect the diversity of the members, clients and communities we serve.

If there\'s something we can do to help make the recruitment process or the job you\'re applying for more accessible, let us know. We can provide accommodations at any stage in the recruitment process. Just ask!

Job Level NV-07

As a Disability Claims Specialist - Case Manager, you help process life and health insurance claims, promote occupational health, and manage disabilities.

You serve as technical expert and provide discipline-specific support for your unit\xe2\x80\x99s activities, initiatives, and processes. The ability to tailor your approach as needed is therefore essential. You research and analyze processes, information management and data processing.

You draw on your sound decision-making skills to solve technically complex problems and recommend ways to change or adjust methods and procedures to make them as effective and efficient as possible.

General Information on the Position

Main responsibilities

Communicate by phone and mail with claimants, policyholders, administrators, other insurers, physicians, government pension plans, workers\xe2\x80\x99 compensation boards and other stakeholders regarding claims. Document follow-up efforts

Process disability claims in accordance with the terms of the group insurance contract

Communicate with the insured and the policyholder to obtain all the information required to establish the causes and context of the absence

Approve and adjudicate claims for disability benefits and process waivers of premium. Communicate its decision to the insured and the policyholder according to the defined process

Carry out specialized technical studies, research, and analysis. Serve as resource person for the submission of solutions and action plans (diagnosis, intervention plan, treatment plan, return-to-work plan, disability monitoring, etc.)

Establish an intervention plan to facilitate the insured\'s recovery and return to work in a timely and sustainable manner for each case of absence treated. Communicate to the insured and the policyholder the content of the intervention and return to work plan and inform the HR practitioner, if applicable, while respecting the confidential information in the file

Define the framework of any personalized support mandate that will be entrusted, at its discretion, to a disability management practitioner or a health professional

Monitor continuously the implementation of this mandate and, when necessary, make the appropriate adjustments as the situation evolves

Establish the amount of the benefit, determine the period payable, proceed with the payment and ensure the necessary follow-ups. Codify and enter data into the appropriate systems

Maintain good relations and act in partnership with external partners involved in absence management

Collaborate in the search for continuous improvement in relation to activities related to disability management and work in collaboration with peers

Prepare documents needed by the organization\xe2\x80\x99s rehabilitation coordinator for claimant interviews. Review claims with medical consultants and the legal department as required.

Other working conditions

Workplace: Position located in Calgary or Manitoba, depending on the applicant selected. The work arrangement for the position is full-time telework #LI-Remote

Number of jobs available: 4

Qualifications

College diploma in a related field

A minimum of 3 years of relevant experience, including 2 years in a similar position in group insurance

Customer service experience

Experience in Direct disability claims mgmt., WSIB, accident benefit, Employer claims mgmt

Experience in the health care field (an asset)

Please note that other combinations of qualifications and relevant experience may be considered

Desjardins Cross-sector skills Action oriented, Customer Focus, Differences, Nimble learning

Key competencies for the job Decision quality, Situational adaptability

Work Location 255 5th Ave. SW Calgary

Trade Union Non Syndiqu\xc3\xa9

Unposting Date 2024-02-16

Job Family Life and health insurance (FG)

Desjardins Group is the largest cooperative financial group in Canada, and one of the largest employers in the country. It offers a full range of financial products and services and is home to a wealth of expertise in property and casualty insurance, life and health insurance, wealth management, services for businesses of all sizes, securities brokerage, asset management, venture capital, and secure, leading-edge virtual access methods.

Desjardins