Senior Bilingual Individual Disability Case Manager

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

📋 Description

• Provide and uphold exceptional customer service for policyholders, agents, and marketing centers.

• Oversee ongoing claims by acquiring necessary medical and financial documentation or conducting investigations as needed.

• Collaborate with specialists across various fields.

• Assess claims and underwriting files to ensure proper disclosure of prior medical history, exclusions, riders, and endorsements.

• Manage policy enhancements, premium waivers, and other policy benefits.

• Evaluate claim benefit eligibility and relay decisions to relevant stakeholders.

• Maintain thorough documentation of claim files to ensure accurate event records.

• Gather appropriate file information and examine policy provisions to confirm eligibility.

• Accurately maintain claim records in the system to support reserve calculations.

• Interact with internal and external clients, service providers, brokers, physicians, employees, hospitals, investigators, and lawyers.

⛳️ Requirements

• A university degree in any field or equivalent experience.

• A minimum of 3 years of experience in claims adjudication, preferably in disability claims.

• Strong focus on customer service combined with effective negotiation skills.

• Advanced knowledge of Microsoft Office (Word, Excel, PowerPoint).

• Fully bilingual in French and English.

• Excellent oral and written communication abilities.

• Familiarity with government legislation and legal precedents; knowledge of the Insurance Act and/or Civil Code of Québec is advantageous.

• Solid understanding of medical conditions and terminology.

• Experience in interpreting and applying financial documentation and fair claims practices.

• Good grasp of underwriting processes.

• Strong analytical capabilities to assess conflicting information, evaluate risks, and make prompt, effective decisions.

• Willingness and ability to work collaboratively in a team environment.

🏝️ Benefits

• Incentive programs and compensation linked to both business and individual performance.

• Health insurance.

• Dental insurance.

• Mental health benefits.

• Vision insurance.

• Coverage for short- and long-term disability insurance.

• Life and AD&D insurance coverage.

• Benefits for adoption/surrogacy.

• Wellness benefits.

• Employee/family assistance programs.

• Retirement savings plans, including a pension.

• Global share ownership plan with employer matching contributions.

• Financial education and counseling resources.

• Paid holidays, vacation, personal, and sick leave.

• Statutory leaves of absence.

• Flexible work environment.

• Opportunities for learning and career advancement.

• Support for inclusion and well-being.

• Reasonable accommodation during the application process.