Bilingual Individual Disability Senior Case Manager

We are currently seeking a Bilingual Disability Senior Case Manager for a client based across Canada. Product lines are Individual Disability and Life Waiver of Premium. The successful candidate must be able and willing to work in a team environment and be motivated to maintain exemplary customer service to our clients.

Responsibilities

• Establish and maintain superior customer service to policyholders, agents, marketing centers.
• Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.
• Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements; administer policy enhancements, premium waiver and other policy benefits.
• Make decisions on claim benefit eligibility determination and communication decisions to stakeholders.
• Document the claim file to ensure an accurate record of events that transpire in the claim handling.
• Obtain proper file information and review with policy provisions to verify eligibility.
• Accurately maintain claim records on system to ensure accuracy of reserve calculations.

Qualifications

• University degree in any discipline or equivalent experience.
• 3+ years of experience in claims adjudication, ideally in disability claims.
• Strong customer service orientation with solid negotiation skills.
• Advanced proficiency in Microsoft Office (Word, Excel, PowerPoint).
• Fully bilingual (French/English): The successful candidate will be required to communicate in English and French in order to support clients from various jurisdictions outside of Quebec.
• Excellent interpersonal skills, with strong oral and written communication skills to interact with internal and external clients, service providers, brokers, physicians, employees, hospitals, investigators, and lawyers.
• Working knowledge of government legislation and legal precedents, the Insurance Act and/or the Civil Code of Québec an asset.
• Strong working knowledge of medical conditions and terminology, with experience interpreting and applying financial documentation and fair claims practices.
• Good understanding of underwriting processes.
• Strong analytical skills to assess conflicting information from multiple sources to evaluate risk and make timely, effective decisions.

When you join our team:

• We’ll empower you to learn and grow the career you want.
• We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
• As part of our global team, we’ll support you in shaping the future you want to see.

The role being advertised is an existing vacancy.