Manage all non-complex and complex claims including but not limited to psychological claims, multiple diagnosis, and co-morbid conditions
Conduct detailed phone functional interviews regarding activities of daily living (ADL) while providing tips to reduce barriers
Evaluate medical and workplace information to determine if key elements are present
Adjudicate all claims in accordance with client and OSI policies, and with a high degree of excellence
Request clinical notes in any claim that requires additional clarity including, mental health claims with pre-existing documentation, identified workplace concerns, unique circumstances, etc.
Enter detailed info regarding the claim, status, communications, and next steps, into the Internal Claims Management System
Ensure a Care Management Action Plan is in place on all files, as required
Manage all claims with a return to work (RTW) focus and for the lowest duration possible and with a continuous improvement impact
Produce appropriate tools to communicate status of claim to clients and claimants (varies based on client)
Requirements Bilingual in French and English including both written and oral
Relevant experience in Disability Management / Claims Adjudication / Return-To-Work Initiatives / STD and LTD Claims Management
Knowledge and understanding of short-term, or long-term disability programs, various treatment programs, and return to work planning and initiatives
Understanding of medical terminology, and common physical and mental health conditions
A registered skilled designation / certification or working towards is an asset: (RN,



RPN, Kin., RRP or other related healthcare background; Certified Disability Management Practitioner / Certified Return to Work Coordinator
Strong proficiency in Microsoft Office and have the ability to learn an internal database system.
Core Competencies Demonstrates expertise in managing complex claims, including psychological and co-morbid conditions, while ensuring compliance with client and OSI policies. Proficient in conducting functional interviews and developing Care Management Action Plans to facilitate effective return-to-work initiatives.
Highest-signal resume keywords Disability Management
Claims Adjudication
Return-To-Work Initiatives
Bilingual in French and English
Microsoft Office Proficiency
ATS Optimization Keywords Hard Skills Claims Management
Medical Terminology
Functional Interviews
Return to Work Planning
Short-Term Disability Programs
Long-Term Disability Programs
Co-Morbid Conditions
Psychological Claims
Adjudication
Care Management Action Plan
Certifications & Qualifications Registered Nurse (RN)
Registered Practical Nurse (RPN)
Kinesiologist (Kin)
Registered Rehabilitation Professional (RRP)
Certified Disability Management Practitioner
Certified Return to Work Coordinator
Industry Keywords Disability Management
Claims Adjudication
Return to Work Initiatives
STD Claims Management
LTD Claims Management
Mental Health Conditions
Physical Health Conditions
Tools & Technologies Internal Claims Management System
Microsoft Office

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📌 Bilingual Disability Management Specialist (Newfoundland and Labrador)
🏢 Jobtailor
📍 Newfoundland and Labrador