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 2–3+ 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.