Job Summary
TeksMed is seeking a Return to Work Coordinator to manage and influence WCB/WSIB claims from intake through resolution. In this role, you’ll partner with employers, injured workers, and healthcare providers to remove barriers, challenge entitlement decisions where appropriate, and drive safe, timely return-to-work outcomes.
Reporting to the Claims Team Leader, you’ll take ownership of new and ongoing claims, analyzing information, guiding clients, and intervening when delays or unnecessary costs arise. You’ll coordinate across all stakeholders to ensure accurate, timely information and determine the best path forward, whether that’s modified duties or further medical support.
This is a fast-paced, outcome-driven role where your analytical thinking and communication skills make a measurable impact for both clients and workers.
Responsibilities
- Receive and action claim files when a factor arises that may delay RTW or add costs to the claims that are not the responsibility of the employer
- To initiate requests for WCB/WSIB Nurse Advisor/Medical Advisor intervention on RTW efforts as appropriate
- To liaise with all parties accordingly to facilitate a RTW when a worker is not cooperating with TeksMed
- Take incoming phone calls from interested parties to either provide information or collect information for those parties
- Seek advice and direction on complex, contentious claims from the Claims Team Leader
- Assess the costs attached to each claim, to best meet the needs of the client
- Prepare and compile information to be presented to WCB/WSIB/Legal Provider on entitlement issues i.e. Modified Duties refusal
- Take the necessary action to ensure that entitlement issues are appealed to the appropriate appeal body as required and within required timeframes
- Manage new and contentious claims until all contentious issues have been resolved.
- Complete a forensic review of high cost claims for new clients and take necessary action in order to facilitate cost recovery
- To participate in Return to Work Meetings between our clients and WCB/WSIB as required
- To initiate requests for cost relief on our client’s behalf and take the appropriate action
- Field inbound and outbound calls to clients, injured workers, physicians or other parties to gather information to assist in ensuring a safe Return-to-Work (RTW)
- Communicate in a consistent and timely manner with the employer and worker
- Arrange and schedule medical assessments, diagnostics, and surgeries as required for WCB/WSIB and STD under the support of the treating physician
- Ensure all documents such as RTW plans, and medical assessments are collected, assessed and actioned
- Continually confirm status of worker, to ensure the RTW is successful
- Make decisions on the next course of action by analyzing medical assessments and client/worker information gathered
- Coordinate with co-workers to ensure accurate and imperative information is reviewed, requested and collected for each claim
- Inform client (by phone, when possible) of outcomes and updates
- Prepare scheduled reports for our clients to provide them with an update on the work being undertaken on their behalf
- Participate in client visits and conference calls as required
- Document successful claims outcomes and generate QuikFacts as appropriate
- Provide assistance and input to Client Care as required on the performance or any issues regarding client’s accounts
- Manage customized software database notes on case files by ensuring accuracy and inclusiveness
- Maintain database by updating information and closing case files once all claims have been addressed and advise all the appropriate parties involved
Expectations
- Initiate NIDMAR certification within 90 days of meeting eligibility requirements
- Demonstrate ongoing and consistent progress toward completion of required NIDMAR coursework
- Successfully obtain NIDMAR certification as a Certified Return to Work Coordinator (CRTWC) within three (3) years of starting in the role, or sooner where eligible
- Provide access to NIDMAR transcripts to support progress monitoring and compliance
- Maintain certification in good standing, including completion of required continuing education (minimum 20 hours annually)
Pay: $45,000.00-$50,000.00 per year
Benefits:
- Casual dress
- Company events
- Dental care
- Disability insurance
- Employee assistance program
- Extended health care
- Flexible schedule
- On-site parking
- Paid time off
- RRSP match
- Tuition reimbursement
- Vision care
- Wellness program
Work Location: In person
