Disability Management Institute

Manager

• Process and manage all Short Term Disability claims, establishing eligibility, calculation of earnings and benefit levels, along with obtaining the necessary medical evidence within the required timelines
• Interview claimants and employers to gather relevant claim information
• Ensure all claims are processed in date order, in accordance with the agreed upon service standards for each Client
• Utilize available resources to assess diagnosis and treatment plans
• Where appropriate liaise in a professional manner with insurance agencies, doctors, employees, management, lawyers…etc., ensuring that only allowable information is released to recognized recipients and that all information is released in writing
• Draft and deliver written correspondence identifying claim activity and next steps
• Participate in claim conference calls with employers
• Work collaboratively with early intervention team to minimize duration of absence and return claimants to work
• Ensure all necessary documentation is provided to the insurance carrier in order for them to process MTD/LTD claims
• Maintain confidentiality over client and corporate records and medical claims information
• Operate automated claims payment system and performs manual calculations as required
• Following training period, a minimum of 95% accuracy is required

STD Case Manager – 15-Month Contract

Claims Specialist

• Review all new referrals from employers with Disability coverage adjudicated by DMI or stand-alone WOP benefits
• Set up clients with Early Intervention services and MTD/LTD coverage as Pre-claim files and refer to the EIP team for app facilitation
• Forward completed claims to the Intake Coordinator for claim set-up and assignment to a Case Manager
• Assemble and submit claims to external carriers following standard procedures
• Respond to all inquiries, emails, and voicemails within 1 business day of receipt

Claims Coordinator, 12-Month Contract

• Assess short-term disability claims for benefit eligibility and render decisions within service standards
• Conduct telephone interviews focused on obtaining pertinent medical and treatment status, functional information, and return-to-work readiness
• Identify and evaluate medical and non-medical barriers and functional abilities to positively impact outcomes
• Develop, communicate, and implement pro-active case management plans
• Collaborate, negotiate, and develop return-to-work plans
• Identify suitable rehabilitation referrals in keeping with employer disability and absence policies and costing
• Utilize external and internal resources to progress files forward to resolution, focusing on function and gainful employment
• Collaborate with healthcare providers and physicians, written or verbal, based on the needs of the claim
• Manage external referrals, services, and relationships with service providers and strategic partners through research and knowledge of local community resources
• Demonstrate understanding of employer-specific resources (i.e. EFAP) and coordination of the same
• Serve as an expert claims management resource for customers and internal business units
• Engage in professional interaction with all stakeholders on a regular basis, including timely and efficient follow-up to telephone and email communication
• Provide timely, detailed documentation to ensure progression and fulfillment of case management plans

Disability Case Manager, Employer Services

Administration

• Complete assigned tasks in DMS3 within 2 business days, including medical request follow-ups, provincial authorizations, CPPD/QPPD applications, Pre-X Forms, and WCB file requests
• Coordinate payments with Finance for police report requests, provincial requests, and specific medical requests
• Manage all Disability and Life & Living department inquiries in a friendly and professional manner
• Provide accurate, plan-specific information to clients
• Devise solutions to administrative issues by investigating, researching, and asking the right questions
• Attend regularly scheduled meetings with the designated Case Manager team
• Manage all correspondence received for the DMI Claims team
• Upload and process medical invoices accurately and on time
• Respond to CSR WOP inquiries within 2 business days and all other inquiries within 1 business day
• Assist in testing system updates and identifying system discrepancies

Claims Support Administrator – 12-Month Contract

Consultant

• Assess ATP-STD or DMCS claims for benefit eligibility
• Render recommendations within service standards
• Conduct telephone interviews with a focus on obtaining pertinent information including medical/treatment status, functional information, and RTW readiness
• Identify and evaluate medical and non-medical barriers and functional abilities
• Develop, communicate, and implement proactive case management plans
• Identify suitable rehabilitation referrals as required
• Identify and utilize external and internal resources to progress a claim to resolution
• Engage in professional interaction with all stakeholders on a regular basis
• Adhere to entering accurate billing
• Provide timely, detailed documentation to ensure progression of the claim
• Attend team scrums and meetings and offer support and coverage to other team members as needed

Disability Case Manager – Consultant

Bilingual

• Interview claimants and employers to gather relevant claim information
• Ensure all claims are processed in date order, in accordance with the agreed upon service standards for each Client
• Utilize available resources to assess diagnosis and treatment plans
• Draft and deliver written correspondence identifying claim activity and next steps
• Participate in claim conference calls with employers and team lead
• Work collaboratively with the Rehab Coordinator to minimize duration of absence and return claimants to work
• Maintain confidentiality over client and corporate records and medical claims information
• Operate automated claims payment system and performs manual calculations as required

STD Case Manager – 15-Month Contract

Claims Coordinator, 12-Month Contract

Disability Case Manager, Employer Services

Claims Support Administrator – 12-Month Contract

Disability Case Manager – Consultant

Bilingual – French Case Manager