Website Workplace Safety and Insurance Board
Job Description:
Manage cases that are allowed, denied, reconsidered or resolved within established program guidelines, following a structured case management framework to enable them to achieve high quality eligibility decisions and successful outcomes.
Job Responsibilities:
- Ensuring accident reporting compliance with the employer.
- Proactively collect information from workplace parties and healthcare providers required for eligibility decisions and respond to inquiries.
- The employer is covered under the Act;
- Support workplace parties in their return to work (RTW) efforts by sharing any available information about the workers’ capabilities and/or precautions.
- Refer requests to appropriate internal WSIB parties (Nurse Consultant, Account Specialist, Legal Services) to gain their expertise on various components of a claim when the need for appropriate intervention is recognized and follow up with them as required.
- Attempt to prevent or resolve disputes, handle requests for reconsideration and, if unresolved, arrange access and process the objection.
- Inform parties of their rights, responsibilities and obligations under the WSI Act and applicable legislation, and the consequences of non-compliance.
- Assess case and plan towards best outcomes. Make eligibility decisions quickly and accurately and communicate them, verbally and in writing by determining the following:
- With the assistance of Payment Specialists where required, ensure appropriate earnings information is on file in order to determine the appropriate duration and level of benefits.
- Review and monitor cases until closure or transition to a Case Manager, assessing RTW and recovery factors to differentiate cases requiring Case Manager expertise.
- The diagnosis is compatible with the accident;
- The injury is work-related;
- Continuity and compatibility support ongoing entitlement in the case of recurrence;
- Proof of accident can be established;
- Perform other related duties as assigned or required such as participation in the development and implementation of business plans and projects.
- The worker is employed by the employer at the time of the injury;
Job Requirements:
- Two years prior experience in adjudication and customer service.
- University completion at undergraduate level.
Job Details:
Company: Workplace Safety and Insurance Board
Job Category: Government
Vacancy Type: Full Time
Job Location: Hamilton, Ontario, CA
Application Deadline: N/A
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