Conseiller / Conseillère en indemnisation des accidents du travail – Niveau 2

This is a fully remote position, open to applicants in Canada.

📋 Description

• Evaluate and handle intricate or technically challenging workers' compensation claims

• Conduct investigations and gather pertinent information to assess claim exposure

• Oversee claims via action plans to ensure timely and appropriate resolutions

• Negotiate settlements within assigned authority limits

• Compute and allocate timely and suitable claim reserves while ensuring reserve adequacy

• Calculate, approve, and disburse benefits, and finalize claims within authority

• Prepare all necessary statutory filings within legal limits

• Manage litigation processes to achieve timely and cost-effective resolutions

• Coordinate vendor referrals for investigation or litigation management

• Implement cost-containment strategies and foster strategic vendor partnerships

• Oversee claim recoveries, including subrogation, Second Injury Fund excess recoveries, and offsets related to Social Security and Medicare

• Report claims to excess carriers and respond to direction requests

• Maintain communication regarding claim activities with claimants and clients while sustaining professional client relationships

• Ensure proper documentation of claim files and accuracy in claims coding

• Refer cases to supervisors and management when necessary

• Contribute to organizational quality programs

• Perform additional assigned responsibilities

⛳️ Requirements

• Bachelor's degree from an accredited institution is preferred

• Professional certification relevant to the line of business is preferred

• A minimum of five (5) years of claims management experience or a comparable combination of education and experience is required

• Expertise in insurance principles and laws, including recoveries, offsets, deductions, claim and disability duration, cost containment principles, medical management practices, and procedures for Social Security and Medicare as applicable

• Exceptional oral and written communication skills, including proficiency in presentations

• Proficient in PC usage, including Microsoft Office applications

• Strong analytical and interpretive abilities

• Excellent organizational capabilities

• Good interpersonal skills

• Outstanding negotiation abilities

• Capability to work collaboratively in a team environment

• Ability to meet or surpass service expectations

• Willingness to travel as necessary

🏝️ Benefits

• Work-life balance

• Inclusive and barrier-free recruitment and selection processes

• Accommodation support during recruitment, if needed

• Equal opportunity employment