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Short Term Disability Case Manager

Tundra Solutions Techniques - Québec

This is a Full-time position in Toronto, ON posted August 8, 2017.

The Toronto Group Disability Claims department is looking for a customer service oriented individual to join their team as a STD Case Manager. Reporting to the Associate Manager, Disability Claims, the STD Case Manager will be responsible for analyzing and adjudicating short-term disability claims while maintaining excellent customer service with Plan Sponsors. 

• Provide short-term disability claim assessment 
• Identify, obtain and analyze key medical, contractual and eligibility information 
• Develops case management plans that identify direction, issues and action plan including methodology and timing to resolve 
• Reviews and provides recommendations to Appeals Specialist on first appeals 
• Make appropriate disability determinations to ensure contractual obligations are met and claims effectively managed 
• Obtain medical and functional information through interviews, standard and customized questionnaires and written correspondence directed at claimants, policyholders and physicians 
• Identify, investigate, resolve or develop recommendations to address and resolve issues identified by internal and external parties 
• Review issues in light of applicable contractual, legal, medical, procedural system and client specific requirements to achieve a resolution 
• Ensures benefit and payment accuracy on short term disability complex claims 

• University degree is an asset, or related experience 
• Knowledge and ability to apply appropriate disability risk management tools and techniques 
• Ability to plan, develop and implement goal-oriented claim management plans 
• Ability to interpret and apply group contract provisions 
• Sound knowledge of medical terminology, medical management and pharmacology 
• Previous group disability experience would be an asset

Skills Required

  • Education level: University
  • Work experience (years): 0-2 years


Salary: N/D