Disability Claims Specialist, Group Insurance

Posted 3 days ago

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About the role

  • Disability Claims Specialist assessing claims and navigating employer relationships for Group Insurance. Collaborating across teams to manage sensitive decisions and ensure compliance.

Responsibilities

  • Adjudication: Fairly and objectively assess disability claims using a multidisciplinary approach, prioritizing critical tasks while ensuring compliance with policies, procedures, and regulatory requirements.
  • Communication: Deliver clear, empathetic, and timely communication to clients, employers, and partners, particularly when handling sensitive decisions such as claim denials.
  • Critical Analysis & Decision Making: Use critical thinking to make informed, timely decisions based on thorough evaluations of claim details.
  • Negotiation and Resolution: Clearly articulate claim decisions in writing and verbally to address concerns, foster mutual respect, and manage escalations effectively.
  • Claim Management: Efficiently and accurately manage a high-volume caseload, calculate benefit payments, and implement return-to-work strategies to support claimants’ recovery.
  • Stakeholder Building: Cultivate strong relationships with key stakeholders and claimants to facilitate recovery and successful return-to-work outcomes.
  • Cross-Functional Collaboration: Collaborate seamlessly with medical, legal, and client service professionals to ensure consistency and drive positive results throughout the claims process.
  • High Sustained Concentration and Mental Processing: Maintain focus and mental acuity to effectively handle complex cases and high-volume workloads.

Requirements

  • Post-secondary education in healthcare or a related field, or equivalent work experience.
  • Minimum 2 years in Short Term or Long-Term Disability claims.
  • Exceptional verbal and written English skills, with the ability to navigate emotionally sensitive conversations empathetically and professionally.
  • Excellent problem-solving and decision-making skills with demonstrated ability to manage complex information and make evidence-based decisions
  • Strong analytical skills to manage complex information and make evidence-based decisions.
  • Ability to work independently with strong organizational and time management skills to strategically deliver the greatest impact.
  • Ability to meet the technological and confidentiality requirements of the role (internet connectivity, and private space)
  • Proficiency in digital tools, Microsoft Outlook, Excel, Word, and ability to navigate multiple systems.
  • Basic math skills and an understanding of financial information.
  • Learning Agility: Adaptability and resilience in managing change and evolving processes.
  • Proficiency in French

Benefits

  • A Total Rewards program that includes flexible benefits
  • Work/life balance and career development programs and investment and retirement savings plans
  • Competitive pay and high-earning potential
  • All the tools, training, and team support you need to grow your career
  • Flexible work/life balance options

Job type

Full Time

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

Associate's Degree

Location requirements

OnsiteMississaugaCanada

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