Job Description

Organizational Solutions Inc. (OSI) is a Third party provider who specializes in Disability Management, believing in the quality of growth and the professional potential of all our staff. Founded in 2003, OSI's journey is one of entrepreneurial achievement and professional development. Over the past fifteen years we have grown from a grassroots start-up into one of Canada's leading Disability Management and Workers' Compensation Claims management providers. Today OSI employs more than 130 highly specialized people and serves over 1,000 clients of all sizes in almost every industry.

As a member of OSI you can have the opportunity to work in an innovative environment and to engage in meaningful work and having a strong positive impact in providing, The Right Care, at the Right Time, for the Right Outcome." within a dynamic, and talented team, while growing your own professionalism.

Overview / General Purpose:

The Disability Management Specialist role is responsible for managing the day to day disability claims (STD / LTD / Accommodations) for clients, assist in facilitating recovery, and promoting early and safe return-to-work for clients' employees. They live to OSI's values of return to work and recovery. Disability Management Specialists will communicate with key stakeholders in order to adjudicate, manage, return-to-work planning, and reporting. Support Disability Management Coordinator (DMC) and Abilities Assessor (AA) on complicated files. In conjunction with the performance of claims adjudication, claims management, and return to work. The Disability Management Specialist will also evaluate historic claims performance and work collaboratively with our team to provide solution-focused programs, and develop best practices for claims and care management, for ongoing and new clients. Establish and maintain positive client relationships. Deliver quarterly and annual reports with continuous improvement focus.

Primary Duties and Responsibilities:

Adjudication of all claims in accordance with client and OSI policies

Enter detailed info into internal management system

Manage all claims with a RTW focus and for the lowest duration

Facilitation of return to work, as soon as possible

Work as part of a team internal and externally with client

Partner with client to understand workplace

Provide continuous improvement impact

Manage all claims with a high degree of excellence

Manage all complicated claims including but not limited to psychological claims

Evaluate medical and workplace information to determine if key elements are present

Explore innovative technologies to reduce durations, i.e. cognability, pharmacogenetics

Develop outcome focused recovery and RTW plans

Communicate the employee's functional capabilities to the employer to determine if the employer is able to provide modified duties in the return to work planning

Facilitate RTW consistently with a Transitional Return to Work Plans (TRTWP)

Finalize annual reports to be presented to client

Coach and mentor other disability management staff by enhancing their knowledge and education levels

Determine when additional tools are to be used at the appropriate times (i.e.: IME / FCE, refer to rehabilitation, medical consultant, pharmacogenetics, or workstation evaluations etc.)

Ensure the employee is receiving optimal treatment at all times

Facilitate treatment plan with treating physician and / or specialist

Conduct detailed phone functional interviews regarding activities of daily living (ADL) while providing tips to reduce barriers

Interact with other to enhance claim outcomes

Provide support to AA, DMC, and guidance on client specifics and decision process / protocol

Aware of status on claims at all times, ensuring internal system is fully updated

Provide strong strategies to reduce claim duration

Organize and participate in monthly client calls and meetings

Brainstorm with Team Lead on any claims over 30 days

Calculate and communicate benefit payment amount for specific clients on their approved claims for each relevant pay period to both the employee and the employer to be paid out by the client or OSI

Monitor the progressive return to work plans

Follow up with any missing claim actions or information

Ensure reported comments updated at least weekly

Review monthly reports

Act as Client Lead on non CL accounts

Review and deliver annual and/or quarterly report, where no Client Lead is in place, with positive and continuous improvement focus

Work collaboratively as part of client team

Participate in brainstorming and committees to advance OSI, i.e. training, social committee, etc.

Establish individual goals consistent with organizational focus and client deliverables

Required Competencies:

Registered professional designation / certification or working towards is an asset: (RN, RPN, Kin., RRP or other related healthcare background; Certified Disability Management Practitioner / Certified Return to Work Coordinator

Relevant experience in Disability Management / Claims Adjudication / Return-To-Work Initiatives / STD and LTD Claims Management

Solid understanding of mental health conditions, treatment, and return to work

Strong negotiation skills

Critical Thinking Skills, analytical reasoning

High sense of urgency and organization / prioritization skills

Excellent Customer Service and communication skills

Able to work as a key member of a team as well as independently

Ability to work within set procedure and policy to ensure the privacy protocols and standard operating procedures are adhered to at all times

Strong proficiency and skills in the Microsoft Office Suites, and have the ability to learn an internal database system

Abide by company policy, i.e. no gossip, Health & Safety, etc.

Pursuit of mastering

Working Conditions:

Occasional travel to client locations when needed - Less than 5%

OSI is committed to gender equality and social inclusion in our workplace. All qualified applications will receive consideration without regard to sex, gender identity, gender expression, sexual orientation, race, ethnic origin, color, religion, nationality, disability, age, or any other characteristic protected by applicable law. We encourage all qualified persons to apply particularly Indigenous peoples, persons with disabilities, ethnic minorities, visible minorities, and others who share our values and contribute to fostering an inclusive and diverse workplace.

Organizational Solutions Inc. is committed to fair and accessible employment practices.

We will accommodate people with disabilities during the recruitment, assessment, hiring processes, and employment. Please notify us as soon as possible of any adaptive measures you might require at any stage of the recruitment process.

Job Types: Full-time, Permanent

Expected hours: 40 per week

Benefits:

Casual dress Company pension Dental care Disability insurance Employee assistance program Extended health care Flexible schedule Life insurance Paid time off RRSP match Tuition reimbursement Vision care Work from home
Work Location: Hybrid remote in Burlington, ON L7L 5L1