Case Manager
Permanent full-time
FUNCTION:
Alberta Blue Cross has an opening for a permanent full-time Case Manager. This position is responsible for providing expert advice to internal and external customers regarding the following lines of business - Weekly Indemnity (WI)/Short Term Disability (STD) and Long Term Disability (LTD), on a daily basis. As required, the Case Manager is also assigned to handle Life, Accidental Death and Dismemberment (AD&D), Dependent Life and Critical Conditions (CCB) claims.
DUTIES AND RESPONSIBILITIES:
. Responsible for assessment of Weekly Indemnity (WI)/Short Term Disability (STD) and Long Term Disability (LTD) claims (including those for Supplementary Unemployment Benefits) and subsequent assessments, which include rehabilitation coordination and calculations. The Case Manager is responsible to ensure proper application of rules and regulations as outlined in the Group Contract and Canadian Life and Health Association Guidelines (previously Superintendent of Insurance Guidelines). In order to do this, interpretation of these rules and regulations and contracts are required.
. Responsible for assessment of Life claims and approval or declination within authorized limits, which includes the calculation of interest. Communication with group administrators, beneficiaries, police, coroner's office, etc. is required. The Case Manager must be able to deal with the beneficiaries who often are very distraught. The Case Manager is also responsible for all correspondence with all parties concerned - verbal and written.
. Responsible for communicating effectively with physicians, rehabilitation consultants, investigative services and claimants both verbally and in writing. Reviews files with medical consultant on a regular basis. Is required to compose letters requesting appropriate detailed medical information from the physicians and other treatment providers. This position also requires constant communication with employees who have physical or mental medical conditions. Communication with authorized investigative service personnel regarding activities check on claimants may also be performed.
. Communicate with internal Alberta Blue Cross departments which, include Medical Underwriting, Group Underwriting, Sales, Group Administration to provide information regarding claims activities as well as receive information regarding eligibility of claimants, Accounting - financial transactions of claims.
SKILLS AND KNOWLEDGE:
. Must have a minimum of 5 years related experience and or education in case and disability management.
. Must possess knowledge of the insurance benefit industry.
. Requires analytical skills and detail orientation.
. Requires excellence in the decision-making process especially when under pressure.
. Requires strong team player skills and attitude.
. Requires excellent written and verbal communication skills.
. Requires strengths in the area of flexibility, innovation and independence.
. Requires strong organizational skills.
. Must be able to deal effectively with the public, peers, and co-workers.
. Knowledge and experience in Microsoft Word and Excel will be an asset.
. Enrollment in LOMA courses would be an asset
Alberta Blue Cross offers a competitive salary and benefits package and the opportunity to work in a challenging team-oriented environment. This position will remain open until a suitable candidate is selected. If you have the qualifications we are looking for, please apply online at www.ab.bluecross.ca
Attention: Janna Kuzik