Sr. Claims Specialist Job Description
Reports to: Team Lead
Employment Responsibilities
· The Team Lead works with the Sr. Claims Specialist determining what claims are to be transferred to the Senior Claims Specialist, with the following parameters being in place:
o Maximum Medical Recovery not obtained > 6 months;
- Claims costs over > $50,000;
- Other non-compensable legal / material issues (i.e. Non-Cooperation, additional complications due to stakeholders);
- Wage replacement benefits paid > 120 days; and,
- Client Request to be escalated.
- Manage High Impact Claims – remove obstacles;
- Call to the WCB’s to obtain any missing information and move the files along;
- Complete medical follow-ups (Return to Health Plans);
- Complete return to work follow-ups (Return to Work Plans);
- Complete return to work meetings;
- Respond to client inquiries; and,
- Provide Account Manager with detailed breakdown of next steps for training purposes
Qualifications:
· Minimum of 3 years work experience in a workers’ compensation claims management capacity either at the WSIB/WCB (or a similar provincial workers’ compensation board-commission) or in an in-house capacity at a private company with corresponding knowledge of workers’ compensation statutes, policies and procedures, experience rating analysis and workplace health and safety.
· Supervisory experience and a high level of oral and written communication skills.
· Ability to work within a demanding and fast paced environment
· Personal initiative and ability to work independently and to meet deadlines
· Familiarly with Microsoft products
· Post secondary education, preferably in a related field, or a human resources and or health and safety and or insurance certificate designation are assets. In absence of these qualifications, significant consideration will be given to applicants with claims management experience.
· Paralegal license would be an asset.
- This is for a current open position
Pay: $50,000.00-$60,000.00 per year
Benefits:
- Company pension
- Dental care
- Disability insurance
- Employee assistance program
- Life insurance
- Tuition reimbursement
- Vision care
- Work from home
Work Location: Hybrid remote in Ottawa, ON K1P 6L5
