Claim Adjudicator jobs

Job Summary

The Officer, Workers Compensation Claims is responsible for acting as a point of contact for all stakeholders in establishing new disability claims, providing status updates and responding to inquiries. As the front line for all Return to Work programs at CN, the incumbent assists the Manager, Workers Compensation in assessing barriers to successful and timely return to work. The role applies sound judgement and accuracy in the setup of disability claims and in the communication of information to all stakeholders involved in employee claims.

This role will have a strong focus on managing hearing loss files; candidates must have demonstrated experience handling noise-induced hearing loss claims, including representation at the appeals level in Quebec

Main Responsibilities

Workers Compensation Board (WCB) Claims Management

• Review all new claims and enter all available data into Systems, Applications and Products (SAP) within 24 hours of receiving notification of an injury

• Review, investigate, and gather additional information to validate each new injury claim and report it to the provincial WCB

• Communicate with employees and managers on a regular basis to assist in the claims process, monitor treatment plans, and determine Return to Work opportunities

• Review medical documentation throughout the life of each file to validate that diagnosis continues to relate to original injury

• Liaise with provincial WCB in Return to Work planning and claims requiring secondary reviews, appeals and medical arbitration

• Initiate and represent CN in secondary reviews, appeals and medical arbitration within legislative deadlines at Provincial Tribunals and Appeal Commissions

• Maintain claim files for all employees including claim details, statuses, action plans and Return to Work progress

• Research related WCB policies and legislation to ensure appropriate benefits are being paid to employees

• Initiate review of, manage and resolve long-standing disability claims where employee is totally and permanently disabled, and all opportunities for accommodation have been exhausted

Accommodation for Non-Occupational Injuries

• Gather medical restriction profiles for employees from insurers, occupational health services and physicians

• Work with regional stakeholders in finding suitable accommodations

• Document data into SAP for all non-occupational claims

• Coordinate Return to Work and monitor employee progress while on accommodated duties

Account Management

• Manage financial portfolio of between $5M - $10M

• Ensure efficient account management

• Review invoices and validate all costs

• Represent CN as a member of each respective Regional Employer Group

Working Conditions

The role has standard working conditions in an office environment with a regular workweek from Monday to Friday. The role requires minimal travel (between 10% - 15%) to visit regional offices and during audits. The role requires being available on-call 24/7 to respond to critical incidences. Due to the nature of the role, the incumbent must be able to meet tight deadlines, handle pressure and manage stress.

Requirements

Experience

Disability Management

• Between 3 to 5 years of hands on experience in disability management and insurance

o Previous experience in workplace accommodation and claim resolution

o Employment at a provincial workers compensation board*

• Any experience for these above would be considered as an asset

Education/Certification/Designation

• Bachelor’s Degree in a related Healthcare Field, Social Science, Business, Human Resources or comparable work experience

o National Institute of Disability Management and Research Certification*

• Any designation for these above would be considered as an asset

Competencies

• Addresses risks in a timely manner to eliminate them

• Shares timely information within and across functions to get things done effectively

• Collaborates with key internal stakeholders to enable higher productivity

• Builds and maintains an internal network to support a better overall work experience

• Inspires others with impactful communications and adapts to the audience

• Influences by translating expertise into practical business outcomes

• Applies analytical thinking to make recommendations that pursue sustainable performance

• Deals with pressure and change by staying calm to quickly adapt to changes

• Fluently bilingual both written and verbal (English, French)*

• Any skills/attributes for these above would be considered as an asset

Technical Skills/Knowledge

• Proficiency in Microsoft Office

• Knowledge of disability management tools

• General knowledge of the railway industry

• General knowledge of Federally regulated employers

• Strong knowledge of applicable provincial Workers Compensation legislations, policies and business procedures

• Knowledge of Canadian and Provincial Human Rights laws

• Knowledge of ergonomic principles*

• Any knowledge for any of the above would be considered as an asset

About CN

CN is a premium railroad that sustainably generates value for our customers, shareholders, employees, and stakeholders with an unwavering commitment to safety and service. Essential to the economy, to the customers, and to the communities it serves, CN safely transports more than 300 million tons of natural resources, manufactured products, and finished goods throughout North America every year. CN's network connects Canada's Eastern and Western coasts with the U.S. South through a 20,000-mile rail network. CN and its affiliates have been contributing to community prosperity and sustainable trade since 1919. CN powers the North American economy and is committed to programs supporting social responsibility and environmental stewardship.

At CN, we are dedicated to building North America's safest, most inclusive and sustainable railroad, which includes reflecting the communities in which we operate. Research shows that candidates often don't apply unless they feel they fit the job posting at 100%. To all potential applicants, even if you don't meet every job requirement listed in a posting, we still encourage you to apply. If you require an accommodation for the recruitment process (including alternate formats of materials, accessible meeting rooms or other accommodations), please get in touch with our team at cnrecruitment@cn.ca.

As an equal opportunity employer, qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, and other protected status as required by applicable law.

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