Workers’ Compensation Consultant – Level 2

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

📋 Description

• Evaluate mid- to high-level workers’ compensation claims to ascertain the benefits that are due

• Ensure the continual adjudication of claims aligns with the company's standards and industry best practices

• Identify subrogation claims and engage in settlement negotiations

• Assess compensability and the benefits owed for long-term indemnity claims

• Oversee reserve accuracy and file necessary documentation with the relevant provincial or state agency

• Create and manage action plans for workers’ compensation claims until resolution

• Coordinate return-to-work initiatives and authorize claim payments

• Approve and process assigned claims in accordance with the relevant claim or client contract

• Communicate claim actions effectively to claimants and clients

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

• Handle complex lifetime or defined-period medical claims, as applicable, including provincial/state and physician filings along with treatment decisions

• Maintain professional relationships with clients

• Support the organization’s quality initiatives

• Execute other assigned responsibilities

⛳️ Requirements

• Bachelor’s degree from an accredited college or university is preferred

• Four (4) years of claims management experience, or a comparable combination of education and experience, is required

• Proficient understanding of regulations, offsets and deductions, disability duration, medical management practices, and Social Security and Medicare application processes relevant to the line of business

• Exceptional oral and written communication skills, including presentation abilities

• Proficient in computer usage, particularly Microsoft Office products

• Strong analytical and interpretive abilities

• Excellent organizational skills

• Good interpersonal abilities

• Outstanding negotiation skills

• Capability to work effectively within a team environment

• Ability to meet or exceed service expectations

• Willingness to travel as necessary

🏝️ Benefits

• Work-life balance

• Inclusive, barrier-free recruitment and selection processes

• Accommodation support during the recruitment process, if necessary