Job Description
Director, Disability Claims
Hybrid Role - Downtown Toronto
Leadership /Technical Disability Claims Knowledge/Presentation Skills
Your role as Director, Disability Claims is of key importance in delivering on our stewardship of superior disability case management while ensuring that claims is proactively manage and closed in a timely manner.
When our client sells an employee group disability insurance policy, our client is selling their expertise in claims adjudication and management. The client's claims management is balanced, demonstrating an empathetic understanding and approach to our claimants while at the same time following an evidence-based objective medical model.
You will be the final decision-maker on claims adjudication recommendations from their outsourced claims team. Your decision may include providing further guidance for the review of the claim based on your deep disability claims management expertise. You will share that expertise through maintenance of the Claims Manual, collaborating with Human Resource teams at key clients and reviewing the capabilities of claims team members.
Major Responsibilities
•Reviewing and authorizing claims recommendations
• The Company is an expert on disability claims, disability treatments, investigations, and related claims activities
• Work closely with the claims team and legal counsel to effectively manage litigated cases
• Ensuring accountability through the claim service chain • Reviewing and authorizing appropriate treatment and measuring efficacy
• Deploying the appropriate medical and vocational specialists to work with employers and employees with the common goal of return to work
• Work with team members and colleagues to identify opportunities and solutions for process improvement and automation
• Ensuring that company's claims adjudication methodology and service standards is adhered to.
The Right Fit For The Role
• You are an expert in disability claims management
• You enjoy sharing your knowledge and experience with colleagues and customers
• You are comfortable making evidence-based decisions that can be supported if contested by claimants, clients, or legal counsel
• You believe in the importance of early intervention and active case management
• You understand the importance of data and reporting in the management of the claims, the team and the sharing of outcomes with the senior leadership team
• You enjoy knowing that everything you do has a direct and measurable impact on the organization
Attributes
• Expert knowledge of disability claims acquired through a minimum of 8-10 years of group benefits experience, must be in a claims leadership role
• Strong written, presentation and verbal communication skills and comfortable in a client-facing role
• A decision maker
• Comfortable representing the company in mediations and lawsuits
DGA Careers has been proudly serving the Canadian insurance industry for over 30 years, specializing in providing insurance recruiting services to major insurers, insurance brokerage firms and independent adjusting firms. With offices in Toronto, Vancouver, Montreal, Edmonton, and Calgary, DGA Careers is well positioned to conduct searches with a national scope. Our unrivalled professional network across Canada provides us with the ability to reach vital key influencers and passive candidates nationally.
Interested candidates please contact Antonella Leone at 647-624-9609