What is the opportunity?
As a Clinical Specialist, you will analyze medical information on disability claims in a team-oriented, multi-disciplinary digital environment. You will also proactively partner with claim adjudicators, doctors and rehabilitation specialists to provide input, set clinical direction and implement clinical strategies across multiple product lines for Life & Health Claims to deliver effective service solutions to enhance outcomes. You will participate in projects and initiatives.
What will you do?
- Responsible for critical analysis of medical information on Life & Health claims to determine extent and impact of medical/psychiatric condition, medical restrictions and limitations and expected duration of medical condition
- Deliver cost efficient work product and for effective utilization of resources in order to maintain cost and appropriate risk management activities
- Responsible for identifying and ordering information from treatment providers crucial to manage the disability claims
- Responsible for conducting due diligence on prospective Independent Assessment providers and ensure vendors comply with contract including fee structure, departmental guidelines as well as company specific requirements
- Assist with developing and implementing claims management and return to work strategies on their assigned caseloads
- Take ownership of client problems through first call resolution coaching and escalate as appropriate
What will you need to succeed?
- RN or BSCN designation in nursing required
- Bilingualism in French and English, both written and spoken
- 5 years’ experience of current, proven clinical experience, in occupational health, rehabilitation or case management, industrial disability management, worker’s compensation, psychiatric, cardiac, emergency care or orthopedic nursing
- Demonstrated ability to effectively deal with customers in a manner that is professional with a high degree of customer service
- Proficiency in MS Office application, PowerPoint, and\or similar applications
- Strong analytical and decision making skills as well as excellent oral and written communication skills
Nice to have
- Impact and influence, including strong conflict management and negotiation skills
What’s in it for you?
- A Total Rewards program that includes flexible benefits, work/life balance and career development programs and investment and retirement savings plans
- Competitive pay and high-earning potential
- All the tools, training, and team support you need to grow your career
- Flexible work/life balance options
- Sophisticated RBCI software tools to boost your productivity
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