Creditor Claims Case Manager
We are seeking a case manager to manage a fluctuating caseload of new and ongoing Creditor disability, life and critical illness claims within department time and quality standards.
In a high volumes environment, you'll handle claims in an efficient and effective manner while maintaining positive relations with claimants, financial institutions and other parties involved in the claim.
Disability case management is executed through the planning and implementation of strategies to manage claims through recovery and/or closure, in the shortest time possible given the nature and severity of the disability.
Your responsibilities will include:
• Determining initial eligibility for benefits in accordance with the Certificate of Insurance.
• Creating and carrying out case management strategies for ongoing claims to effectively manage the claims through recovery or closure. This includes obtaining and evaluating medical and other relevant information, and setting the expectations with the insured.
• Providing timely verbal and written communication explaining the coverage, claim process, and decision.
• Assisting with claims appeals by obtaining and providing information.
• Maintaining file documentation that is precise, accurate, and objective to meet legal standards.
• Interacting on a daily basis with claimants suffering from physical or mental illnesses in an empathetic yet firm manner.
The successful applicant will possess the following qualifications:
• EITHER an Undergraduate university degree, preferably in Science or Business Administration, and a minimum 4 to 5 years related industry experience. OR High school graduation diploma plus 1 year post secondary education along with 6 to 8 years industry experience, with a minimum of 2 years in claims adjudication or claims assistant experience, along with an in-depth knowledge of medical terminology.
• Completion of LOMA Level 1, CSI, ICA 1 & 3 (or working on these courses) would be an asset.
• Willing to complete Associate ALHC designation.
In addition, you'll also possess the following skills:
• Proven excellence in communication in French & English (both written and oral)
• Strong critical thinking analysis and decision making abilities
• Superior organizational skills and ability to multi-task.
• Proven dedication to customer service
• Demonstrated initiative and drive
• Strong sense of urgency
• Good conflict resolution, negotiation and problem solving skills
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