Disability Specialist - Quality Assurance
Ontario Teachers Insurance Plan (OTIP)
Location
Waterloo, ON | Canada
Job description
Who We Are
With every job, there’s always the question of “why”. Why join a company? Why be part of their mission? Here, the why is easy. It’s because at some point, we’ve all needed someone there for us.
At the OTIP Group of Companies (OGC), we believe that something special happens when employees feel valued for the work they do, supported as the people they are, and included in the very fabric of the organization: they bring their best to work every day. And that's why we mean it when we say we put our people at the centre of everything we do. Join us as we grow our way into a future that reimagines what it means to deliver meaningful benefits support and service.
Job Description
What You’ll Do:
Reporting to the Manager, Quality Assurance Program, you’ll be responsible for responsible for quality assurance reviews for Group Life and Disability Claims (GL&DC) claims and rehabilitation staff, as assigned. This includes completing technical and standard operating procedures, file/case management and call observation quality assurance reviews as assigned. This role also includes effectively communicating quality assurance results to GL&DC staff verbally and in writing. The Disability Specialist will also serve as a member of the Appeal Committee when required.
The core parts of your role will be to:
- Works as a member of the Quality Assurance team to conduct regular quality assurance audits of GL&DC staff as assigned.
- Completes quality assurance reviews and provides results of technical, file/case management, rehabilitation, and call observation audits in accordance with contractual and administrative policies established within the GL&DC department.
- Collaborates effectively with Quality Assurance & Training teams by continuously reviewing QA audits, sharpening training needs, and reviewing GL&DC best practices.
- Effectively communicates quality assurance results and maintains confidentiality related to an individual’s audit results.
- Works closely with the GL&DC management team as it relates to an individual’s results.
- Easily adapts to change as it relates to amendments on audit review focus to meet the requirements of GL&C business needs.
- Acts as a senior resource to GL&DC claims employees and managers. This may include taking employee referrals on complex claim situations, contractual interpretation and assigned projects.
- Maintains technical knowledge by attending educational workshops, reviewing publications, and participating in continuous learning.
- Supports change within GL&DC, works effectively in a team environment and contributes to overall team goals and workload management.
- Required to Intermittently join Appeal Committee Meetings to review appeal claims, discuss the case with other committee members and render a final appeal decision.
- Performs other duties with competence, as assigned. This may include but is not limited to, the release of information requests, involvement in arbitration or litigated claims and participation in GL&DC projects.
Qualifications
Let’s Talk About You:
This is the unique blend of skills and experience we would love to see in an ideal candidate:
- A university degree or college diploma in a related subject.
- A minimum of five years’ experience in long term disability claims adjudication within the insurance field.
- Strong knowledge related to long term disability claims management, rehabilitation, payments, insurance principles and practices, industry standards, and legal and contractual obligations.
- Exceptional communication skills and the demonstrated ability to deal effectively with all levels of internal and external stakeholders.
- Superior time management and organizational skills to manage competing priorities, including project management skills.
- Intermediate knowledge of Microsoft Office Suite applications.
- The ability to communicate in French is considered an asset.
- A background in rehabilitation is considered a strong asset.
We also consider your potential. If you know you have what it takes to do the job, but your experience doesn’t exactly match the
qualifications
above, we encourage you to apply and provide us with more details about why you think you would be a great fit.
Additional Information
Some of the Perks We Offer:
We offer best-in-class pension and benefits, total reward programs and comprehensive mental wellness supports to set you up for every success in and outside of work. Here are just some of the reasons you’ll love working here:
- Rewarding salary and bonuses that truly value your dedication
- Industry-leading group benefits with 100% premium coverage (excluding LTD) that start on your first day
- Defined benefit pension plan for a financially confident retirement
- 100% coverage of approved continuing education and licensing fees (including RIBO courses in Ontario)
- Access to a wealth of learning resources, including LinkedIn Learning for professional development
- Flexible work-from-home and hybrid options
- Unlock your potential with opportunities for advancement
Let’s work together! If you are interested in this opportunity, please apply online.
OTIP and its group of companies strive to create an accessible and inclusive work environment where everyone is treated with respect and dignity. Upon individual request, reasonable accommodation will be provided in all parts of the hiring process as required. Please contact Human Resources at [email protected] to request an accommodation.
As a business, we protect what matters most to our members. As an employer, we value what matters most in our workplace. Together, this includes fostering a diverse, equitable and inclusive environment for all. We are committed to learning and evolving so we can continue to celebrate what makes us special. You are who you are, and our differences are what make us unique.
We are an equal opportunity employer and encourage applications from all qualified individuals. We thank all applicants for their interest; however, only candidates selected for an interview will be contacted.
#LI-Remote, #LI-Hybrid
Job tags
Salary