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Careers

Claims Adjudicator

Posted Date Jun 23, 2022
Closing Date Jul 11, 2022
Department Employee Benefits
Location Regina
Job Type Permanent Full Time
Hours of Work 37.50 hours per 1 week rotation
Salary Pay Band 4 with a salary range of $69,051 to $89,766
Expected Start Date Aug 15, 2022
Number of Positions 1

Job Summary

The Employee Benefits team, in collaboration with health system partners, recently completed a 3-year strategic plan to re-design the disability claims management model. Providing collaborative support with beneficiaries on their path to health using an active case management approach. 

Our Claims Services team is seeking a Claims Adjudicator who will be responsible for assessing and managing short and long-term disability claims to resolution. This includes determining if the plan member is eligible to receive benefit payments, developing a case management plan for each claim, and working with the plan member through a successful return to work. The Claims Adjudicators work in partnership with claimants, member organizations, unions, physicians and rehabilitation consultants. The Claims Adjudicator makes timely decisions based on medical information, vocational components, and plan policies, while effectively and proactively managing a caseload of ongoing claims.

The philosophy of our Employee Benefits department is “We Take Care of the Caregivers”.  Our Claims Adjudicators work in partnership with a team of professionals to care for the caregivers in our province.  This could be the career for you if you have a positive attitude, a commitment to quality service, and thrive in a fast-paced work environment.

Required Qualifications

  • Degree/Certification in Human Resources, Disability Management or Occupational Health and Safety is preferred
  • Experience in vocational rehabilitation, disability management or attendance support would be an asset

Knowledge, Skills & Abilities

  • Ability to establish and maintain effective interpersonal/consultative relationships including conflict resolution;
  • Ability to handle calls of a sensitive or emotionally charged nature;
  • Ability to identify root cause of issues and develop/recommend solutions;
  • Ability to manage time and set personal goals and priorities to achieve department results;
  • Ability to understand customer needs and identify improvement opportunities;
  • Ability to work independently and as a member of a multi-disciplinary team;
  • Demonstrated ability to establish and maintain effective working relationships with both internal and external customers;
  • Excellent written and verbal communication skills, and high attention to detail;
  • Knowledge of group insurance principles and practices, industry standards, legal and contractual obligations, and claims investigation and assessment procedures an asset;
  • Medical knowledge as well as demonstrated knowledge in aspects of human behaviour, counseling, interviewing, referral procedures and community resources; and
  • Must have a positive attitude, a commitment to quality service and ability to cope with the stress inherent in the nature of disability claims adjudication, including high work volumes.

Other Information:

  • Knowledge of lean processes would be considered an asset

Experience

  • A minimum of 5 years' experience in insurance and/or disability claims adjudication, or an equivalent combination of education and experience.
  • Medical experience obtained through claims assessing, underwriting, nursing or a health profession is an asset.

How to Apply

To be considered for this position, all candidates must submit a cover letter and resume.

To apply for this position, please click the button below. Prior to commencing employment with 3sHealth, the selected candidate will be required to complete a criminal record check.  

We thank all interested candidates; however, only those chosen for an interview will be contacted.