QUALIFICATIONS and COMPETENCIES REQUIRED:
• Degree in Nursing or any allied medical course with at least 2 yrs. Related experience in disability case management and with strong BPO healthcare experience and excellent written and verbal communication skills (French and English)
• Proficiency with computer and Windows PC applications; Ability to multi-task and prioritize work items to meet client service standards and Sun Life best practice guidelines; attentive to details
• Critical thinking and analytical skills with customer service focus and a passion for solving challenging situations
• Resilient; collaborative but can work independently; identifies opportunities for process improvement
RESPONSIBILITIES:
• Adjudicate disability claims for eligibility, reviewing and analyzing contractual, medical, functional, occupational information, and identify influencing factors, functional capability and restrictions and limitations and utilize available interventions as appropriate.
• Work collaboratively with insured employees, clients, lawyers, healthcare practitioners and other stakeholders to obtain information through phone interviews, provide claim status, create action plans and communicate verbal and written decisions in both English and French languages
• Participate in face to face (virtual) client meetings and engage in continuous learnings about disability practices and tools