• Work-life balance with flexible working hours of 7 hours per day, Monday to Friday (i.e., 35 hours per week).
• Paid vacation starts at 3 weeks per year, and increases with years of service.
• Hybrid work environment (i.e., a combination of work from office and work from home days).
• Generous benefits, including extended health, dental, and life insurance; these benefit premiums are 100% paid by PBC.
• Education allowance up to $1,000 per calendar year.
• Onsite gym, cafeteria, and access to virtual doctors/counsellors 24/7 via our Employee Family Assistance Program!

• We are searching for 1 Temporary up to 12 months Disability Claims Management Specialist 2 to join our Work & Wellness department.
• This position is unionized and part of the CUPE 1816 Bargaining Unit. This position is paid at hourly rates and receives wage increases in accordance with the Collective Agreement. The starting wage for this position is: $35.85 per hour.

• reviewing, analyzing, and investigating claims and history/conditions of claimants to determine eligibility information from a variety of sources as well as requesting and documenting additional information as required.

• identifying and following up on variances in policy and structure set up in the claims adjudication system or other deficiencies such as variances between policy provisions and eligibility.

• investigating pre-existing conditions and other policy exclusions to determine impact on eligibility and valuation

• conducting telephone interviews and/or communicating in writing with claimants, policy holders, employers, treatment providers, lawyers, brokers, third parties, and other stakeholders in the disability claims process to gather claims-related information, determine level of functionality, determine status of accommodation, return to work, and/or necessary intervention and case management services including independent medical evaluations and functional capacity evaluations, and probe further into circumstances giving rise to the claim through the application of professional interviewing protocols and documentation skills.

• deciding on the acceptance or denial of the claim and other decision outcomes, preparing, and documenting the rationale for the decision, making internal round table presentations to colleagues and management to ensure claims-related decisions meet professional and quality standards, and communicating the final decision to claimants and employers.

• developing initial and ongoing cost-benefit analyses for intervention options and case management plans to identify the most cost-effective approach to managing disability claims without compromising on contractual obligations; estimates probable and potential outcomes and factors those outcomes into the development and costing of the case management plan.

• developing case management plans and early intervention including setting plan expectations and outcomes, preparing, and referring case files to external stakeholders for assessments and medical treatment and management such as clarifying objectives of the referral and coordinating return to work plans with the employer. Coordinating referrals to internal stakeholders for rehabilitation. May coordinate settlements for insured clients.

• coordinating and overseeing the services of treatment providers to facilitate recovery for disability claims.

• coordinating and overseeing, with internal stakeholders, the services of internal and external rehabilitation services.

• developing, implementing, and monitoring return-to-work initiatives including modified, accommodated, and graduated return-to-work programs, and taking required action if situations change.

• regularly reviewing high intervention short-term and long-term disability cases to facilitate treatment optimization and return-to-work planning through referrals to internal and external stakeholders as required.

• identifying and calculating amounts for recovery where Canadian Pension Plan (CPP), Workers' Compensation Board (WCB) benefits, other sources of income/benefits, motor vehicle accidents prior to 2019, or earlier than expected return-to-work have or may result in overpayment; communicates recovery amounts and expectations for repayment to all affected parties, and follows up to ensure recovery.

• ensuring documentation and claim status is continually updated in the systems.

• High school graduation, or equivalent.
• Completion of a 1-year Disability Management Diploma (288 hours), or equivalent.
• Demonstrated proficiency in basic Word and Excel.
• 3 years of previous related experience in disability claims management with 2 years in a Disability Claims Specialist or Disability Claims Management Specialist 1 position, or equivalent.
• Demonstrated proficiency in disability claims management including assessment, oversight of interventions and claim resolution.