By joining Sedgwick, you''ll be part of something truly meaningful.

Its what our 33,000 colleagues do every day for people around the world who are facing the unexpected.

We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance.

Here, theres no limit to what you can achieve.

Conseiller / Conseillre en indemnisation des accidents du travail Niveau 2 / Workers Comp Consultant - Level 3 OBJECTIF : Analyser les demandes d''indemnisation des accidents du travail des cadres moyens et suprieurs afin de dterminer les indemnits dues; veiller ce que le traitement des demandes soit conforme aux normes de l''entreprise et aux meilleures pratiques du secteur; reprer les demandes de subrogation et ngocier les rglements. PRINCIPALES FONCTIONS ET RESPONSABILITS Traiter les rclamations dindemnisation des travailleurs en dterminant la recevabilit et les indemnits dues pour les rclamations dindemnit long terme, surveiller lexactitude des provisions et dposer la documentation requise auprs de lorganisme provincial. laborer et grer les plans daction des rclamations dindemnisation des travailleurs jusqu leur rglement, coordonner les efforts de retour au travail et approuver les paiements des rclamations.

Approuver et traiter les rclamations attribues, dterminer les indemnits dues et grer le plan daction conformment la rclamation ou au contrat du client.

Grer la subrogation des rclamations et ngocier les rglements.

Communiquer les mesures relatives la rclamation avec le demandeur et le client.

Veiller ce que les dossiers de rclamation soient correctement documents et que la codification des rclamations soit exacte.

Peut traiter des rclamations mdicales complexes vie et/ou pour une priode dfinie, incluant les dpts auprs de la province et des mdecins ainsi que les dcisions concernant les traitements appropris recommands par lexamen de lutilisation.

Maintenir des relations professionnelles avec les clients. AUTRES FONCTIONS ET RESPONSABILITS Accomplir d''autres tches qui lui sont assignes.

Soutenir le(s) programme(s) qualit de l''organisation.

Voyager si ncessaire. QUALIFICATIONS Formations et permis Baccalaurat obtenu dans une universit ou un tablissement d''enseignement suprieur agr, un atout.

Exprience Quatre (4) ans dexprience en gestion des rclamations ou une combinaison quivalente de formation et dexprience.

Comptences et connaissances Connaissance pratique des rglementations, des compensations et des dductions, de la dure de l''invalidit, des pratiques de gestion mdicale et des procdures de demande de scurit sociale et d''assurance maladie applicables au secteur d''activit concern.

Excellentes comptences en communication orale et crite, y compris en prsentation.

Matrise des outils informatiques,



notamment des produits Microsoft Office.

Comptences analytiques et interprtatives.

Solides comptences organisationnelles.

Bonnes aptitudes interpersonnelles.

Excellentes comptences en ngociation.

Capacit travailler en quipe.

Capacit respecter ou dpasser les attentes en matire de service.

Were hiring Workers Compensation Consultants! If you have experience handling Workers Compensation claims across Canadian jurisdictionsor background in absence management, leave administration, STD/LTD adjudicationwed love to have you on our team.

Ideal candidates will bring: Paralegal expertise for handling claims, appeals, and compliance matters Strong knowledge of workers compensation legislation and health & safety standards Proven ability to manage complex claims processes and collaborate with stakeholders Experience in HR leave programs, disability case management, and policy interpretation If you are passionate about supporting colleagues through challenging times and ensuring compliance, we want to hear from you! PRIMARY PURPOSE : To analyze complex or technically difficult workers'' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers'' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Prepares necessary state fillings within statutory limits.

Manages the litigation process; ensures timely and cost effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.





Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.

Communicates claim activity and processing with the claimant and the client; maintains skilled client relationships.

Ensures claim files are properly documented and claims coding is correct.

Refers cases as appropriate to supervisor and management. ADDITIONAL FUNCTIONS AND RESPONSIBILITIES Performs other duties as assigned.

Supports the organization''s quality program(s).

Travels as required. QUALIFICATIONS Education & Licensing Bachelor''s degree from an accredited college or university preferred.

Professional certification as applicable to line of business preferred.

Experience Five (5) years of claims management experience or equivalent combination of education and experience required.

Skills & Knowledge Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations Job type: This posting is to create a candidate pool for future opportunities Compensation Information: Salary Range : $65,000 - $80,000 CAD annually Compensation is determined based on experience, qualifications, and internal equity.

Sedgwick is committed to transparent and equitable pay practices.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.

They are not intended to constitute a comprehensive list of functions, duties, or local variances.

Management retains the discretion to add or to change the duties of the position at any time.

Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates.

These tools are subject to periodic review.

We are committed to inclusive, barrier-free recruitment and selection processes.

If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.

📌 Conseiller / Conseillère en indemnisation des accidents du travail – Niveau 2 / Workers Comp Consultant - Level 3 (Quebec City)
🏢 Sedgwick
📍 Quebec City