Claims Adjudicator, Employee Benefits (5048)

Job Posting

Claims Adjudicator, Employee Benefits
Organization:  3sHealth
Province:  Saskatchewan
Location:  Regina
 
Salary: 
Description:

Who we are:

3sHealth is an innovative and entrepreneurial organization based in the vibrant downtown of Regina and is recognized as one Saskatchewan’s Top Employers for the third year in a row. 3sHealth provides province-wide shared services to support Saskatchewan’s health system. Working together with our health system partners, we find innovative solutions to complex problems so that health care will be sustainable for future generations. We place patients and their families at the centre of all that we do, working with our partners to improve quality and ensure patient safety. 3sHealth provides payroll and scheduling services, employee benefits, dictation and transcription services, linen services, and provincial contracting services to the Saskatchewan health system

The Opportunity:

The Employee Benefits team, in collaboration with health system partners, is embarking on a 3-year strategic plan to re-design the disability claims management model. This plan includes reframing claims management from adjudication to an active case management approach. This change positions the claims services area to provide improved service and collaborative support with plan members on their path to health.

We’re seeking a Claims Adjudicator who is responsible for assessing and managing short and long-term disability claims to resolution. This includes determining if the claimants are eligible for benefit payments and developing appropriate action plans for each claim. The Adjudicator works in partnership with claimants, member organizations, unions, lawyers, 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.

Requirements:

What we’re looking for:

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.

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 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 identifying improvement opportunities.
  • Ability to work independently and as a member of a multi-disciplinary team.
  • Effective use of MS Office Suite and database applications.
  • Excellent written and verbal communication skills, and high attention to detail.
  • Medical knowledge as well as demonstrated knowledge in aspects of human behaviour, counseling, interviewing, referral procedures and community resources.
  • Knowledge of group insurance principles and practices, industry standards, legal and contractual obligations, and claims investigation and assessment procedures an asset.
  • Ability to handle calls of a sensitive or emotionally charged nature.
  • 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.
  • Knowledge of lean processes would be considered an asset.


How to apply:

To express your interest in this opportunity, email your cover letter and resume by July 3, 2019 to careers@3sHealth.ca.

For more information about 3sHealth, visit www.3sHealth.ca.

Prior to commencing employment with 3sHealth, the selected candidate will be required to complete a Criminal Record Check.

We thank all applicants, however, only those selected for interviews will be contacted