AddressDescription
Job Summary:
Determines claim acceptability and entitlement to benefits under the Workers Compensation Act for all claims. Gathers information and responds to inquiries. Communicates decisions and works with injured workers, employers, their representatives, and caregivers as it relates to the claim.
Manages the delivery of customer services work injury claims by determining ongoing responsibility, coordinating early and ongoing medical intervention, facilitating early return to work, communicating decisions to concerned parties, responding to inquiries and complaints, and determining benefits. Coordinates referrals of customers to internal and external programs aimed at the goal of returning the customer to work and recovery.
The Customer Care Facilitator will be the primary contact person on all claims and has the overall responsibility for the explanation and communication of information internally and externally.
Qualifications:
University degree in business, health care, education or social sciences/ disability management
One year of successful experience providing direct claims management, applying acts/regulations or policies in decision-making, assuming responsibility for actions and demonstrating the ability to:
organize work efficiently
set priorities appropriately
complete work within established time frames
effectively communicate orally and in writing
problem-solve
make sounds decisions with minimal supervision.
This position is a field position. As such, it is necessary for an individual to have a valid class 5 drivers license to occupy the position.
