Representative, Adm Claims Management

1. Develops ADM claims processes to ensure the effective and efficient management of Attendance Support, Direct Referral Services and LTD claims within Fraser Health.
2. Processes employee LTD claims the Great West Life Assurance Company (GWL) through activities that include: filing relevant documents with GWL; acting as a resource and contact for internal and external LTD inquiries and referring to appropriate team member where necessary; providing information and assistance to employees and managers/supervisors during the qualifying period and application process; following up with department managers/supervisors to ensure LTD claims documentation contains required information and ensures all information is forwarded to the appropriate parties within established timeframes; responding to inquiries from managers/supervisors and staff on the status of LTD claims; liaising with GWL during initial stages of claim to verify details regarding the acceptance and time loss of a claim including proposed treatment/rehabilitation plan and options for modified return to work, if needed; monitoring LTD claims on an ongoing basis for return to work opportunities; and, updating appropriate stakeholders.
3. Monitors employee absence rates and identifies appropriate candidates for follow up in accordance with the Attendance Support Mandate. Provides clarification to staff and managers regarding options for support through ADM to mitigate absence from work . Generates applicable correspondence regarding individualized employee information such as absence rate, sick bank hours, sick time hours related to LTD qualifying period, short-term benefit plan information, available resources and contact/support information, and medical form requirements. Liaises with managers to outline meeting expectations and provides toolkit of resources. Inputs data into Attendance database to track intervention outcomes.
4. Provides service referral information to direct referral providers/vendors, and obtains new provider invoicing information. Manages provider invoices by confirming provision of service and requesting approval to pay from DM Client Partners, liaising with Finance to ensure payments are processed. Inputs above data into WHITE database.
5. Collaborates with the Disability Management Client Partner to effectively manage ADM cases by compiling and monitoring reports on the status of Attendance Support services, Direct Referral services and LTD claims, liaising with Managers/Supervisors, Payroll and Benefits and GWL as required.
6. Compiles, analyses and maintains statistical data; produces and distributes summaries and reports as required; receives correspondence from external parties such as service providers and GWL, and enters relevant information into appropriate database.
7. Performs a variety of administrative duties such as preparing correspondence, reports, policies/procedures, minutes, charts and graphs using various software programs.
8. Initiates and maintains efficient manual and electronic filing systems to fulfill required needs.

Diploma in Human Resource Management or equivalent, supplemented by word processing, database and spreadsheet courses and training in claims management plus two (2) years recent related experience in a large multi-union environment, or an equivalent combination of education,and experience.

Demonstrates the leadership practices of the Fraser Health Leadership Framework of Clear, Caring and Courageous and creates the conditions for people to succeed.

Professional/Technical Capabilities

• Knowledge of claims and case management human resource practices and relevant collective agreements.
• Demonstrated ability to effectively deal with staff, third party providers and the general public
• Ability to type at 65 wpm
• Ability to operate related equipment including applicable software applications
• Physical ability to perform the duties of the position

Fraser Health is the heart of health care for over two million people in Metro Vancouver and the Fraser Valley in British Columbia, Canada, on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region.

People - those we care for and those who care for them - are at the heart of everything we do. Our hospital and community-based services are delivered by a team of 48,000+ staff, medical staff and volunteers.

We are committed to planetary health and value diversity in the work force. We strive to maintain an environment of respect, caring and trust. Fraser Health’s hiring practices aspire to ensure all individuals are treated in an inclusive, equitable and culturally safe manner.

Together, we are the heart of health care.

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Please be on alert for potential recruitment scams. We are aware of recent scams targeting individuals by falsely claiming to represent Fraser Health. Always take precautions when sharing personal details with unverified sources. Please note that we will never ask for money or payment at any point during our recruitment process.