2+ years of experience in STD and/or LTD claims management preferred., University degree or College Diploma in a health-related field is preferred., Proficient English communication skills, both spoken and written, are required., Bilingual skills in French and English would be an asset..
Key responsabilities:
Analyze medical and employment information to make decisions on STD claims.
Manage open STD claims and create opportunities for timely resolution.
Provide superior customer service and maintain clear documentation.
Communicate frequently with clients and participate in client meetings.
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At Equitable our belief in the power of working together guides how we work with each other. How we help our clients and partners. And how we support the communities where we live and work. Together, with partners and advisors across Canada, we offer Individual Insurance, Group Insurance and Savings and Retirement solutions.
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But we're not your typical financial services company. We have the knowledge, experience and ability to find solutions that work for you. We're friendly, caring and interested in helping. And we're owned by our participating policyholders, not shareholders. So we can focus on your interests and provide you with personalized service, security and wellbeing.
At Equitable, we realize that your work life is not just about performing a job; it's about being part of a workplace that helps you grow and reach your full potential. Within our friendly and collaborative work environment, we recognize that the key to our growth and success is a dedicated, motivated and client-responsive staff. Join Equitable today.
Position Title: Group Short Term Disability Claims Specialist
Reports To: Manager, Life STD LTD Claims Department : Group Disability Life Claims Term: Permanent Full-Time
Work Arrangements: You will work from your home office 100% of the time. You may be required to be in-person at our office in Waterloo, ON or another assigned location within the Waterloo Region, on an as needed basis. Sales related roles may be required to travel based on the assignment.
The Opportunity: If you love helping people and have a passion for delivering exceptional customer service, you’d be a great fit for our team. That’s because at Equitable, we believe in providing personalized service and support to our plan sponsors and plan members. Our plan sponsors rely on us to deliver creative solutions as we help their staff in their recovery and return to work from an injury or illness. If you have experience in disability adjudication or in a related disability or mental health profession and you want to have a positive impact on the lives of our plan members, we want you to join our company.
We’re looking for a polished communicator and decision maker who can develop creative solutions to complex problems, someone who is empathetic and has a natural service orientation, who is a collaborator that can work with others towards a common goal. If that’s you, why not explore a career as a Group Short Term Disability Claims Specialist at one of the Waterloo Area’s Top Employer for 2025 and Southwestern Ontario’s Top Employers for 2024!
What you will be doing:
Analyze medical, functional, employment and contractual information to make timely and accurate decisions on STD claims
Continually manage open STD claims using proficient problem solving and analytical skills and creating opportunities for timely resolution of the claim
Calculate benefits payable and make any adjustments as required throughout the course of the STD claims. (i.e., offset for CPP Disability Benefits and calculating overpayments, etc.)
Identify and implement cost effective case management tools to assist disabled employees (e.g., Rehabilitation Intervention, Functional Abilities Evaluations, Independent Medical Examinations, Medical Consultant Referrals)
Provide superior written and verbal customer service with accuracy and maintain well-documented, clear, and concise files
Frequently communicate with plan sponsors, plan members, advisors, Group Marketing Managers, medical professionals, legal professionals
Actively participate in client meetings
Professionally communicate with and show empathy to our clients over the phone and email (many are going through extremely difficult periods of their lives and communications may be emotionally charged)
Utilize key problem-solving skills to make tough decisions on claims, clearly communicating these decisions with the client in a way that is easy to understand
Showcase conflict resolution skills to de-escalate situations with unsatisfied clients
What you will bring:
Bilingual skills in French and English would be an asset
Proficient English, spoken and written, is required
2+ years’ STD and/or LTD claims management experience is preferred
University degree or College Diploma preferred in health-related field (i.e. nursing, occupational therapy, kinesio logy, psychology, social services etc.) or experience adjudicating disability claims
Thorough knowledge of insurance operations
Passion for problem-solving and thorough knowledge of insurance operations
Complex knowledge of various group contracts would be helpful
Computer literacy skills
Effective negotiating and conflict management skills
Excellent interpersonal and strong customer service skills
Mathematical & analytical skills
Demonstrated conflict management and professional de-escalation skills
Deep-rooted personal boundaries and time management, with the ability to balance various priorities coming in at once
Ability to break down difficult to understand concepts/decisions and explain in a way that is easy to understand for the client
Proven ability to succeed in a dynamic environment with changing priorities
What’s in it for you:
A healthy work-life balance with employee wellness top of mind
Annual bonus program, annual vacation allowance, and company-paid benefits program
An additional paid volunteer day each year so you can spend time giving back to the community
Immediate enrollment in the company’s pension program with employer matching
Employee resource groups that support an inclusive work environment
Tuition support and specialized program assistance
An onsite full-service cafeteria with a variety of daily options
Discounts on company products and services, and access to exclusive employee perks
Regular EQ Together events focused on company togetherness and collaboration
How do I apply?
Select Apply Now at the bottom of the page and apply to the role through our careersite.
Complete your PLUM profile HERE and complete the Plum Discovery Survey. (Please note that priority will be given to applicants who complete the survey)
As part of the recruitment/offer process you will be required to:
Provide two professional references (minimum one supervisor and above)
This role is open due to an existing vacancy.
To learn more about Equitable, we encourage you to explore our organization.
At Equitable, we are committed to providing equal access to employment opportunities across our organization. Please contact our HR team at careers@equitable.ca if you would like to receive our job postings in an alternative format or require an accommodation with the application process.
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Required profile
Experience
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.