Workers’ Compensation Consultant – Level 3

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

📋 Description

• Evaluate and oversee intricate or technically challenging workers’ compensation claims.

• Investigate claims and collect the necessary information to assess claim exposure.

• Manage claims through action plans to ensure suitable and prompt resolution in line with CNESST requirements.

• Negotiate settlements within established authority limits.

• Calculate and oversee reserves throughout the duration of claims.

• Calculate and disburse owed benefits; approve and process payments and settlements.

• Prepare necessary provincial filings within set deadlines.

• Oversee the litigation process and coordinate vendor referrals.

• Implement cost-containment strategies and utilize vendor partnerships.

• Manage recoveries, including subrogation, Second Injury Fund recoveries, and offsets from Social Security and Medicare.

• Report claims to excess insurers and address requests for direction.

• Communicate with claimants and clients while maintaining professional relationships.

• Ensure precise file documentation and claims coding.

• Refer files to supervisors and management as necessary.

• Support the organization’s quality initiatives.

• Perform other assigned tasks and travel as needed.

⛳️ Requirements

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

• Relevant professional certification in the field is preferred.

• Five (5) years of claims management experience, or a comparable combination of education and experience.

• Proficiency in insurance principles and legislation, recoveries, offsets, deductions, claim and disability duration, cost containment, medical management, and Social Security and Medicare procedures.

• Exceptional verbal and written communication skills, including presentation abilities.

• Proficient in computer applications, including Microsoft Office products.

• Strong analytical and interpretive abilities.

• Excellent organizational skills.

• Good interpersonal skills.

• Outstanding negotiation skills.

• Comprehensive knowledge of provincial workers’ compensation boards, including CNESST.

• Bilingualism (French and English) is mandatory for candidates aiming to work in Quebec.

• Ability to meet or surpass service expectations.

• Capability to thrive in a team environment.

🏝️ Benefits

• Work-life balance.

• Inclusive, barrier-free recruitment and selection processes.

• Workplace accommodation support when necessary.

• Quality program support.