Bilingual Individual Disability Senior Case Manager
Core
Manage individual disability and life waiver claims by adjudicating eligibility, reviewing medical/financial documentation, and communicating decisions to stakeholders.
Role type
Senior Individual Disability Case Manager
Builds
Claims adjudication outcomes and policy benefit administration
Domain
Insurance / Disability Claims
Deliverable
client delivery
Required skills
claims adjudication, medical terminology interpretation, financial document analysis, policy provisions review, eligibility determination, stakeholder communication, Microsoft Office proficiency, bilingual communication (French/English)
Preferred skills
knowledge of Insurance Act and Civil Code of Québec, underwriting process understanding, risk assessment
Responsibilities
Establish and maintain superior customer service to policyholders and agents; manage ongoing claims by requesting documentation and consulting specialists; review claims and underwriting files for proper disclosure; make decisions on claim benefit eligibility; document claim files accurately; verify eligibility against policy provisions; maintain claim records for reserve calculations.