OverviewWorkSafeNB is creating an inventory of casual full-time Claims Adjudicators to support future hiring opportunities. These positions require a bilingual written and spoken profile.Reporting to the Manager, Adjudication Services, you will provide superior client service by rendering quality decisions in a timely fashion on claim entitlement and providing timely access to care for workers. This includes medical aid and loss of earnings entitlement. You will support the worker in their recovery and enable the worker to stay at work and/or return to work. To protect the integrity of the system, you will make decisions in compliance with the Workers’ Compensation Act or any other relevant legislation, and WorkSafeNB policies, directives, and standard operating procedures.Salary And Hours Of WorkHours of work are those required to perform the assigned tasks but shall not be less than 35 hours per week, 7 per day. Monday to Friday between 8:00-5:00 PM.The pay scale for this position is$40.84 per hour. CUPE 1866 employees start at Step 1 of the pay band for the position appointment.ResponsibilitiesProviding quality and timely decisions on claim entitlement in keeping with established service standards by claim type for all new claims, reconsiderations and recurrences while maintaining compliance with legislation, policies and procedures.Communicating the adjudication decisions clearly and concisely by preparing decision letters, in a timely fashion, for workers, employers, service providers, etc., anchored into legislation and policies.Gathering and requesting any information and evidence required to complete and weigh it, using administrative justice principles, to ensure quality and timely adjudication decisions are made in accordance with legislation, policies,



and standard operating procedures.Evaluating and determining if new incoming information is material and substantial and a claim decision should be reconsidered or if a new decision is required.Utilizing disability duration guidelines to educate and create expectations regarding stay at work and return to work options with workers, employers, and service providers. Initialize stay at work or return to work processes.Initiating, supporting, authorizing, and setting up the medical rehabilitation plan (including return to work plans) in accordance with legislation, policies, and standard operating procedures.Evaluating and taking appropriate action on incoming information.Identifying issues impacting the claim, recovery, and stay/return to work and coordinating appropriate referrals when indicated.QualificationsA completed University Degree in business, law, education, health care, social sciences, kinesiology, or a related field.Must have a minimum two years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience such as, but not limited to:Making adjudicative decisions or entitlement decisions or insurance claims decisions based on a defined set of criteria (i.E., policies, procedures, legislation, etc.).Applying law and/or policy to make determinations based on a defined set of criteria (i.E., policies, procedures, legislation, etc.).Caseload management.Managing and assessing workplace-based programs.Working in a health care field with knowledge of medical terminology/issues and an ability to interpret medical reports.Ability to provide superior client service in, sometimes, confrontational,



and sensitive situations.Ability to communicate effectively complex and difficult concepts in a transparent and concise manner, both verbally and in writing.Ability to plan and organize in a fast-paced and high-demand environment with multiple competing priorities. Ability to work under pressure to meet tight deadlines while providing excellent client service.Ability to objectively review information and apply independent reasoning for quality and timely decision-making in a fast-paced, high-volume work environment. Ability to obtain, assess and evaluate information to support claims decisions. This requires a high level of attention to details.Ability to interpret and apply provisions, policies, procedures, and legislation. Understanding of the Workers’ Compensation Act, Firefighters Act and any other relevant legislation and policies.Ability to work and communicate well with others during day-to-day activities and to collaborate with others to achieve team goals.The following equivalent combination of education, training and experience may be considered:A completed two (2) year post-secondary education diploma in business, law, health care or social science-related fields, or a related field with four (4) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.Or a completed one (1) year paralegal post-secondary education diploma with five (5) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.Written and spoken competency in English and French are required for these positions.Note: This description reflects responsibilities and qualifications for planning future hiring opportunities and does not constitute an offer of employment.#J-18808-Ljbffr

📌 Claims Adjudicators - C$40.8 An Hour (Winnipeg)
🏢 WorkSafeNB
📍 Winnipeg