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claims examiner - insurance
Title posted on CareerBeacon - Claim Adjudicators (Permanent and Casual Full-Time Bilingual)
Posted on November 22, 2024 by Employer details WorksafeNB
Job details
Work Remotely Within the Province of New BrunswickThe team at WorkSafeNB is passionate about promoting health and safety in New Brunswick workplaces. We strive to make New Brunswick the safest place to work. However, injuries do occur, and when they do, we are committed to providing caring recovery and return to work services, benefits, and compensation to injured workers and their families. Culture is the heartbeat of the organization. The stronger it is, the further we go! Selected by our employees, our WorkSafeNB values shape our culture. We put our values of Accountability, Collaboration and Trust into ACTion. We demonstrate accountability by taking pride in and ownership of our work so we can take care of our clients and other New Brunswickers. Through collaboration, we build strong partnerships and innovate to achieve better outcomes. Trust guides our organization; we lead and listen with empathy and embrace diversity, inclusion and belonging. These ACTions shape us.WorkSafeNB is looking to hire permanent and casual full-time Bilingual positions for Claim Adjudicators. The normal hours of work for employees in the bargaining unit shall be thirty-five hours per 5-day work week, Monday to Friday, between 8:00 a.m. and 5:00 p.m..Reporting to the Manager, Adjudication Services, you will provide superior client service by rendering quality decisions in a timely fashion on claim entitlement and providing timely access to care for workers. This includes medical aid and loss of earnings entitlement. You will support the worker in their recovery and enable the worker to stay at work and/or return to work. To protect the integrity of the system, you will make decisions in compliance with Workers' Compensation Act or any other relevant legislations, and WorkSafeNB policies, directives, and standard operating procedures.Your key areas of responsibility include:· Providing quality and timely decisions on claim entitlement in keeping with established service standards by claim type for all new claims, reconsiderations and recurrences while maintaining compliance with legislation, policies and procedures.· Communicating the adjudication decisions clearly and concisely by preparing decision letters, in a timely fashion, for the workers, employers, service providers, etc. anchored into legislation and policies.· Gathering and requesting any information and evidence required to complete and weigh it, using administrative justice principles, to ensure quality and timely adjudication decisions are made in accordance with legislation, policies, and standard operating procedures.· Evaluating and determining if new incoming information is material and substantial and a claim decision should be reconsidered or if a new decision is required.· Utilizing disability duration guidelines to educate and create expectation regarding stay at work and return to work options with workers, employers, and service providers. Initialize stay at work or return to work processes.· Initiating, supporting, authorizing, and setting-up the medical rehabilitation plan (including return to work plans) in accordance with legislation, policies, and standard operating procedures.· Evaluating and taking appropriate action on incoming information.· Identifying issues impacting the claim, recovery, and stay/return to work and coordinate appropriate referrals when indicated.You embrace the following competencies:· Client-focused Service· Teamwork and Collaboration· Adaptability· Ensuring Accountability· Decision Making· Analytical Thinking· Written Communication· Information Gathering and Processing· Resilience· Legislation and ComplianceQualificationsCandidates are required to demonstrate on their application all of the qualifications, knowledge, skills and/or abilities in the following areas, in order to be given further consideration:· A completed University Degree in business, law, education, health care, social sciences, kinesiology, or a related field.· Must have a mi- LocationUnknown
- Workplace information On site
- SalaryNot available
- Terms of employment Permanent employmentFull time
- Starts as soon as possible
- vacancies 1 vacancy
- Source CareerBeacon #MB2409050024
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