About the role

STD Case Manager adjudicating short-term disability claims for DMI, a Canadian disability and absence-management provider. Managing medical evidence, benefit calculations, correspondence, and return-to-work coordination remotely.

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 only allowable information 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 records and medical claims information
Operate the automated claims payment system and perform manual calculations as required

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
CDMP or LOMA designation an asset
Medical background an asset, e.g. Occupational Therapist, Kinesiology, Nursing, or Physiotherapist
Ability to work within core business hours
Minimum 95% accuracy required following the training period
Ability to maintain confidentiality of client and corporate records and medical claims information