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Claims Management Advisor

SUMMIT SEARCH GROUP

Toronto, ON, CANADA
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Summit Search Group fosters a collaborative culture that drives positive business results. The work ethic at Summit can be summed up in one word: tenacious. We sort, lift, and dig systematically throughout professional networks, industry connections and our customized database of qualified professionals with a single purpose: to find the best candidates for our clients. We constantly refine our recruiting processes to meet and exceed each and every one of our clients' and candidates expectations. With the use of extensive market research, analytics and deep knowledge combined with our network of nationwide recruiting experts. Summit Search Group has a competitive edge that sets us apart from our competitors.

As Canada's leader in professional and executive recruiting, we have earned the role of trusted partner to our clients. Through open dialogue, the use of technology and attention to detail, we create long-term partnerships with candidates and clients alike.

The Opportunity

Position Scope: 

Our client is looking to add an Occupational Claims Management Advisor.  The Advisor is accountable for the management, coordination, and follow-up for all occupational claims in the region.  This individual will also partner with other team members on a variety of projects.































Responsibilities:

  • Maintain records of active claims and prepare statistical analysis
  • Responsible for the review of claims submissions, Cost Statements, NEER Statements, etc. for accuracy
  • Prepare and submit professional objections for questionable claims
  • Acts as company representative at Appeals/Hearings at the WSIB or in litigation involving the WSIB
  • Acts as a liaison for employees, managers and medical resources involved in occupational claims
  • Identify trends based on statistical analysis and provides recommendations
  • Responsible for effective and efficient case management of WSIB claims across the province
  • Initiate timely interventions to maximize cost avoidance and cost recovery.
  • Support, educate and provide guidance to local Human Resources team members in the timely management of occupational claims, including preparation of a case management action plan
  • In coordination with stakeholders, optimize the development of Early and Safe Return To Work plan
  • Establish and maintain amicable relations with the different bodies involved in Occupational Health and Safety to ensure updated knowledge of laws and regulations applicable for region

 

Required Skills and Knowledge:

  • Thorough knowledge of medical claims analysis
  • Demonstrated working knowledge of Workers' Compensation and Human Rights legislation as it pertains to disability, accommodation and return to work
  • Demonstrated strategic approach to claims management
  • Demonstrated ability to cultivate positive relationships with all stakeholders
  • High level of integrity dealing with confidential information
  • Ability to go the company locations to support local activities or lead particular projects

 

Education and Experience:

  • Degree in Human Resources Management and / or Specialization in Health and Safety management
  • 3 to 5 years of progressive experience in the management of occupational claims
  • CDMP or CRTWC designation an asset
  • Experience in a multi-location environment is a strong asset
  • Experience in management of non-occupational claims is an asset

 

To apply, please send a resume to Allison Dwyer at Dwyer@summitsearchgroup.com.

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