About the role

Case Manager adjudicating Short-Term and Long-Term Disability claims for Alberta Blue Cross. Managing treatment plans, rehabilitation, benefit payments and return-to-work planning.

Responsibilities

Adjudicate Short-Term Disability and Long-Term Disability claims
Apply rules and regulations outlined in the Group Policy and CLHIA guidelines
Plan, implement and evaluate case management principles
Issue correct benefit payments
Communicate professionally and accurately with stakeholders
Manage assigned portfolio and become subject matter expert on assigned groups
Develop and monitor treatment plans
Plan return-to-work and rehabilitation programs
Build relationships with involved parties
Provide expert advice to internal and external customers
Communicate with Medical Underwriting, Group Underwriting, Sales, Group Administration and Accounting regarding claims activities, eligibility and financial transactions

Experience related to disability claims management
Degree or diploma in a health-related field such as Nursing, Kinesiology, Rehabilitation Medicine or Social Work is an asset
Mental Health claims management experience is considered an asset
Knowledge of the insurance benefit industry is considered an asset
Strong analytical, detail orientation and organizational skills
Demonstrated excellence in decision-making, especially under pressure
Strong team-player skills and cooperative attitude
Excellent written and verbal communication skills
Proven flexibility, innovation and independence
Ability to deal effectively with external stakeholders and coworkers
Proficiency with Microsoft Word and Excel is required
Certified Disability Management Professional (CDMP) would be an asset
Enrollment in LOMA or other industry-related courses would be an asset
Satisfactory criminal record check required as a condition of employment following a conditional offer