Experience

La Capitale

• Canada
• Insurance
• 700 & Above Employee

• Disability Claims Case Manager

  • May 2018 - Present



Medavie Blue Cross / Croix Bleue Medavie

• Canada
• Insurance
• 700 & Above Employee

• Disability Claims Specialist

  • Mar 2013 - May 2017

  • Adjudicated Short Term Disability and Salary Continuance claims for various national large accounts • Assessed complex and non-complex claims for benefit entitlement and absence support by reviewing contractual, medical, functional and occupational information • Implemented and evaluated sound case management plans in accordance with employee group disability benefit policies and practices • Responsible for creating, facilitating and managing appropriate return to work plans to support Members return to work • Processed payments accurately • Assessed stand along Life Waiver of Premiums claims • Identified medical and non-medical factors impacting/contributing to a safe and successful return to work • Communicated with physicians and treatment providers to obtain necessary medical information for the claims assessment • Prioritized work in order to meet client service standards and best practice guidelines • Identified and implemented the right interventions to support recovery and return to work, such as rehabilitation potential, IME referrals, etc • Liaised with claimants, policyholders, LTD case managers/carriers, internal/external departments, and medical staff for a timely and effective case management • Conducted detailed telephone interviews to obtain functional and/or psycho-social factors contributing to the absences • Provided prompt, courteous, and knowledgeable customer service to claimants, employers, lawyers, brokers, etc, earning a positive reputation • Handled between 60 to 100 regular claims log Show less



ABML

• Seiden Health Management Inc.

• Disability Case Manager

  • Jan 2008 - Sep 2012



Seiden Health Management Inc

• Medical Practices
• 1 - 100 Employee

• Office Administration

  • Aug 2005 - Dec 2007

  • Managed administrative processes in Occupational Health Services department • Maintained and updated database programs • Provided exemplary administrative support to five full time disability managers and over 70 000 clients • Created claim documentation and prepared, updated and reviewed, various weekly, bi-weekly and monthly reports for clients • Assisted and trained newly hired claim adjusters and administrative personnel • Developed a procedure manual improving the department workflow process • Coordinated pre-placement medical evaluations for clients • Coordinated Travel Health consultations Show less



The Wine Barrel

• Picton, Ontario

• Store Assistant

  • 2005 - Jul 2005



Rex Rent a Car and Limousine Services

• Regional Representative/International Sales Agent

  • Sep 1999 - Sep 2004

  • Effectively marketed full-service car and limousine rental services throughout six provinces in a major business and tourism area of Cuba • Involved in creation of successful advertising campaign which brought about a significant amount of business for the company • Responded kindly and professionally to telephone and written queries from business partners and clients, including highly emotional and disgruntled and/or cognitively disabled individuals • Performed a broad range of customer-oriented services for car rental office • Remained on call 24/7 in order to assist with problematic situations and respond to customer request, consistently ensuring maximum customer satisfaction Show less