About the role

STD Case Manager adjudicating short-term disability claims for DMI, which delivers disability and absence management solutions. Managing medical evidence, eligibility, payments, and return-to-work coordination.

Responsibilities

Process and manage all Short-Term Disability claims
Establish eligibility and calculate earnings and benefit levels
Obtain necessary medical evidence within required timelines
Interview claimants and employers to gather relevant claim information
Process claims in date order according to client service standards
Assess diagnoses and treatment plans using available resources
Liaise professionally with insurance agencies, doctors, employees, management, and lawyers
Release allowable information only to recognized recipients and provide information in writing
Draft and deliver written correspondence identifying claim activity and next steps
Participate in claim conference calls with employers
Collaborate with the early intervention team to minimize absence duration and support return to work
Provide documentation to insurance carriers for MTD/LTD claim processing
Maintain confidentiality of client and corporate records and medical claims information
Operate automated claims payment systems and perform manual calculations

3+ years of claims experience in a group insurance environment
Experience in long- or short-term disability insurance preferred
Post-secondary degree or diploma or equivalent experience
Familiarity with medical terminology and disability contract language an asset
CEBS, CIP, or LOMA designation an asset
Medical background an asset, such as Occupational Therapist, Kinesiology, Nursing, or Physiotherapy
Must work within core business hours
Following training, minimum 95% accuracy required