We are seeking a Bilingual Disability Management Coordinator to join our Organizational Solutions team (OSI).
The Bilingual Disability Management Coordinator is responsible for overseeing the full lifecycle of disability management and accommodation claims, with consults on all complex claims prior to adjudication decision. The role involves conducting a detailed functional assessment, reviewing medical and workplace documentation, adjudicating claims in accordance with organizational and client policies, and providing initial consideration of the return to work on every claim. Maintain accurate and timely documentation and billings within the internal claims management system, and ensure that all claim activities, communications, and next steps are clearly documented and communicated to the client.
This role has a strong focus on facilitating an early, safe return to work by developing and monitoring individualized recovery and transitional return-to-work plans. This includes collaborating with healthcare providers, other key support service partners, health providers, and employers (clients) to optimize treatment and workplace accommodations. Additionally, the role requires ongoing client engagement, participation in strategic discussions, quality reviews, and continuous improvement initiatives.
Manage all non-complex and complex disability management and accommodation claims, including but not limited to psychological claims, multiple diagnoses, and co-morbid conditions
Complete claim consults with designated individuals on all complex claims prior to the adjudication decision on the claim
Conduct detailed phone functional interviews regarding activities of daily living (ADL) while providing tips to reduce barriers
Evaluate medical and workplace information to determine if key elements are present
Execute adjudication of all claims in accordance with client and OSI policies, and with a high degree of excellence
Request clinical notes in any claim that requires additional clarity, including mental health claims with pre-existing documentation, identified workplace concerns, unique circumstances, etc.
Enter detailed information regarding the claim, status, billings, communications, and next steps into the internal claims management system
Ensure a Care Management Action Plan is in place on all files, as required
Review and respond to client instant messages received in the internal claims management system within one (1) business day of receipt
Manage all claims by developing outcome-focused recovery and return-to-work plans that facilitate an early, safe return to work while minimizing claim duration.
Determine when additional tools are to be used at the appropriate times, including IME, FCE, referral to rehabilitation, medical consultant, pharmacogenetics, cognability, or workstation evaluations, etc.
Interact with various key support service partners and health providers to enhance claim outcomes, facilitate treatment plans, and ensure the claimant is receiving optimal treatment at all times
Maintain regular communication with clients to ensure they are kept informed of claim status throughout the claims management process
Communicate the employee’s functional capabilities to the employer to determine if the employer is able to provide modified duties in the return to work planning
Facilitate and monitor Transitional Return to Work Plans (TRTWPs) to support successful return-to-work outcomes.
Complete file reviews with the designated Team Lead on any claims over 30 days
Assist with other ad hoc claims and duties as needed
Record all billable and non-billable time in the internal claims management system
Participate in monthly client calls and meetings as require
Demonstrated ability to collaborate effectively with internal and external stakeholders, contributing to a team-oriented environment while supporting client needs and ensuring service continuity
A strong commitment to performance excellence, accountability, and professional development, while supporting colleagues, achieving key performance metrics, and contributing to continuous improvement initiatives.
Completion of post-secondary education in a related field including healthcare, nursing, rehabilitation sciences, disability management, human resources, occupational health, health and safety, business, insurance, legal and paralegal studies, or an equivalent combination of education and relevant work experience
Bilingual fluency in French and English including both written and oral communication.
Relevant experience in Disability Management / Claims Adjudication / Return-To-Work Initiatives / STD and LTD Claims Management / Healthcare and direct patient care, or other fields with transferable skills applicable to the role
Knowledge and understanding of short-term or long-term disability programs, various treatment programs, and return to work planning and initiatives
Understanding of medical terminology and common physical and mental health conditions
Strong proficiency and skills in the Microsoft Office Suite, and have the ability to learn an internal database system
To identify issues quickly and develop effective solutions through critical thinking and analytical reasoning.
Exceptional communication skills, delivering excellent customer service, collaborating with teams, and interacting with clients professionally.
To build and maintain strong, collaborative relationships with clients, team members, and key stakeholders.
Strong organizational skills, time management, and the ability to prioritize tasks effectively.
To work within established procedures and policies, ensuring privacy protocols and standard operating procedures are strictly followed at all times.
Registered professional designation / certification or working towards (RN, RPN, Kin., RRP, or other related health care backgrounds, Certified Disability Management Practitioner / Certified Return to Work Coordinator) is considered an asset
Certification or completed training in Mental Health and Applied Suicide Intervention Skills (ASIST) is considered an asset
Learn by working alongside our experts.
Extended health care and dental benefits
A retirement savings plan with company contributions
A suite of Health & Wellness offerings
Mental Health programs and support for you and your family
Assistance for the completion of industry designations
Competitive compensation
Organizational Solutions Inc. (OSI) is dedicated to providing exceptional disability management services tailored to the unique needs of organizations across Canada.
We are committed to providing an inclusive, accessible environment, where all employees and clients feel valued, respected, and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. If you require an accommodation or an alternative format of any posting please reach out to [email protected] .
The base salary for this position is between $52,000 - $60,000 annually.
This represents base salary only and does not represent other variable compensation components of our total compensation (i.e. annual bonus, commission). The actual base salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. If you are selected to move forward in our recruitment process, the Talent Acquisition Specialist will be able to provide additional details of the total compensation for this role.
