Intake Adjudicator

WorkplaceNL • St. John's, NL

3d • CA$69,714 - CA$76,913

About The Position

We are currently looking for experienced Intake Adjudicators to work as a critical team member in our Claims Services Department. In this role you will be the expert in determining entitlement to compensation services and benefits. You will be accountable for the review and investigation of complex issues related to adjudication of all medical aid and lost time claims and recurrences.

Requirements

• Completion of an undergraduate degree in health care, social sciences, business or education and two years’ relevant experience.
• Experience in a client centered team environment, with responsibility for interpreting legislation and/or determining entitlement and managing a client case load is preferred.
• Demonstrated decision making responsibilities and abilities, analytical, judgment, problem solving, investigative, research, organizational, interpersonal and communication skills.
• Demonstrated writing abilities.
• Ability to perform mathematical calculations to determine wage loss benefits.
• Medical terminology and an ability to interpret medical reports would be a definite asset.
• Knowledge of various pension plan benefits.
• An understanding of the health care delivery system in the province would also be an asset.
• Knowledge of Workplace Health, Safety and Compensation legislation, policies and procedures and the ability to apply the concepts and principles of worker’s compensation in varying situations.

Responsibilities

• Reviewing and investigating complex issues related to adjudication, benefit approval and payment of all lost time, third party, hearing loss, workplace fatality and industrial disease claims.
• Determining the relevancy of each piece of evidence, applying the proper weight to the evidence and determining whether further evidence is necessary.
• Calculating benefit rates for the initial 13 weeks on all new lost time claims. In cases where the payment is greater than 13 weeks, the Intake Adjudicator determines and establishes the long-term earnings base rate.
• Investigating all employer objections and corresponding with all involved parties prior to determining entitlement.
• Providing a detailed written decision, ensuring the worker’s privacy is protected.
• Resolving any questions of disputed entitlement.
• Ensuring claims are adjudicated within a timely manner to meet duration and client service goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level