Medical Adjudication jobs in Remote

Position Type:

Permanent

If you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.

As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.

Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.

The next cohort will begin in mid-January 2027

Apply today and secure your new Career with Medavie!

As a Disability Claims Specialist, you will be working and collaborating with a dynamic and talented team of professionals in a high-energy work environment supporting our members through illness, recovery and return to work by providing them with disability benefits and proactive case management.

In this role you will help members to realize their potential for productive lives, to the best of their abilities.

At Medavie you have the flexibility to work from wherever you're most productive and inspired — be it your home office, a few days at home or at work or full time in our offices.

Key Responsibilities:

• Responsible for the disability claim adjudication from the initial decision to building the right case management plan including identifying the supports needed for each case, monitoring treatment and the achievement of the plan, and working with the claimant, employer and providers involved in the case.
• Active case management of files, providing regular communication with all stakeholders and assessing the use of claims tools (rehab etc.) and requesting ongoing medical as needed.
• Provide assessment of key dates within the lifecycle of the claim and ensure case management plans are updated regularly.
• Ensure that required tasks within the assigned case load meet service level standards.
• Render timely and potentially difficult decisions and effectively communicate these decisions, while managing escalations with employers and claimants.
• Build effective relationships with key stakeholders (the claimants, the treatment providers and physicians, the employers, group administrators, human resources, and lawyers) to support recovery and return to work.
• Ensure effective and consistent use of our electronic case management syste m.
  

Qualifications

• Education: University degree or a completed college diploma related to occupational health, disability management, kinesiology, Education, Human Resources, Legal Study areas are assets but are not limited.

Work Experience:

• Relevant work experience in disability claims management or insurance benefits case management, including assessing eligibility and managing an active caseload.

• Demonstrated experience making and communicating complex case decisions, managing competing priorities independently, and guiding clients through difficult situations.

• Experience reviewing contracts, medical documentation and reports to assess claims, support decisions and develop case management plans is an asset.

Computer Skills:

• Proficiency working with Microsoft Office applications (Word, Excel and Outlook).

• Strong technical aptitude: You can multitask and navigate between multiple software applications simultaneously while ensuring detailed online notes and tracking of information.

Language skills:

• Bilingualism (English and French) is required to perform the duties of the role, which include daily collaboration with teams and partners in Canada who operate in both languages.

Professional Experience:

• Exceptional written and oral communication skills.
• Well-developed organizational and prioritization skills.
• Positive attitude with a drive to succeed and a commitment to quality service.
• You have an innovative mindset to improve operational efficiencies and ability to influence change, with a primary focus on client needs.
• Experience providing customer care, support, and assistance with the ability to communicate complex and difficult information clearly.
• Strong initiative, leadership, and strategic thinking.
• Excellent problem-solving with the ability to work independently and with all levels of the organization.
• Ability to maintain a high degree of accuracy in a fast-paced environment.

We've got you covered!

• Flexible work arrangements and emphasis on work-life balance

• Comprehensive health, vision and dental plan that is 100% employer paid effective on your first day.

• 100% employer-matched Defined Contribution Pension Plan.

• Annual Incentive Bonus which recognizes your contribution to our success.

• Paid vacation and additional Vacation Purchase Program.

• Wellness benefits, health resources and fitness center discounts.

• Learning: To set you up for success, you will participate virtually in our 15-week paid training program, which will provide you with the necessary education, tools and resources required. While in training, you will be surrounded with colleagues who have your best interest at heart and will continue to support you as you gain your autonomy.

• Career Growth: We offer a career path encouraging you to follow your passions, learn new skills and focus on growing your career with Medavie.

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Pay Rang e: $69,934.53 – $81,954.53 (CAD)

This posting is for an existing vacancy within our organization / Ce poste est actuellement vacant au sein de notre organisation.

The Base Pay range may vary depending on the successful candidate or other relevant job-related factors such as knowledge, skills, qualifications, experience and education/training. In addition to Base Pay, eligible Medavie employees may participate in various performance-based incentive programs. Payments under these programs are discretionary and subject to both individual and organizational results.

We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws . We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.

While Medavie may use automated tools, including AI, to support application screening, candidates are expected to complete all recruitment interactions independently—without AI assistance—to ensure a fair and equitable process.

If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca .