Representative, Adm Claims Management

Fraser Health continues to be recognized as one of BC's Top Employers, are you someone who is passionate about making a difference in the lives of others?

Fraser Health is responsible for the delivery of hospital and community-based health services to over 1.9 million people in 20 diverse communities from Burnaby to Fraser Canyon on the traditional territories of the Coast Salish and Nlaka’pamux Nations. Our team of nearly 45,000 medical staff and volunteers is dedicated to serving our patients, families and communities to deliver on our vision: Better health, best in health care.

All new hires to Fraser Health must have full COVID 19 vaccination (have received a full series of a World Health Organization “WHO” approved vaccine against infection by SARS-COV-2, or a combination of approved WHO vaccines). Please note this applies to all postings, and individual medical exemptions must be approved by the Provincial Health Officer.

Take the next step and apply so we can continue the conversation with you.

Come work with dedicated health care providers who are enthusiastic and committed to provide quality healthcare to our clients/patients/residents. We invite you to find out why more than 95% of new employees recommend Fraser Health as an excellent place to work. Work hard and have fun while you do it.

Curious to learn what it’s like to work here? Like us on Facebook (@fraserhealthcareers), follow us on Twitter & Instagram (@FHCareer), or connect with us on LinkedIn (fraserhealthcareers) for first-hand employee insights.

Supporting the Vision, Values, Purpose and Commitments of Fraser Health including service delivery that is centered around patients/clients/residents and families:

Responsible for providing effective claims management and administrative support for the Absence and Disability Management (ADM) process; supports the provision of Attendance Support, Direct Referral Services and Long Term Disability (LTD) benefits to employees, managers and Human Resources/Organization staff by assessing customer needs and applying Workplace Health /Human Resource policies, procedures and collective agreement provisions.

1. Develops ADM claims processes to ensure the effective and efficient management of Attendance Support, Direct Referral Services and LTD claims within Fraser Health.
2. Processes employee LTD claims the Great West Life Assurance Company (GWL) through activities that include: filing relevant documents with GWL; acting as a resource and contact for internal and external LTD inquiries and referring to appropriate team member where necessary; providing information and assistance to employees and managers/supervisors during the qualifying period and application process; following up with department managers/supervisors to ensure LTD claims documentation contains required information and ensures all information is forwarded to the appropriate parties within established timeframes; responding to inquiries from managers/supervisors and staff on the status of LTD claims; liaising with GWL during initial stages of claim to verify details regarding the acceptance and time loss of a claim including proposed treatment/rehabilitation plan and options for modified return to work, if needed; monitoring LTD claims on an ongoing basis for return to work opportunities; and, updating appropriate stakeholders.
3. Monitors employee absence rates and identifies appropriate candidates for follow up in accordance with the Attendance Support Mandate. Provides clarification to staff and managers regarding options for support through ADM to mitigate absence from work . Generates applicable correspondence regarding individualized employee information such as absence rate, sick bank hours, sick time hours related to LTD qualifying period, short-term benefit plan information, available resources and contact/support information, and medical form requirements. Liaises with managers to outline meeting expectations and provides toolkit of resources. Inputs data into Attendance database to track intervention outcomes.
4. Provides service referral information to direct referral providers/vendors, and obtains new provider invoicing information. Manages provider invoices by confirming provision of service and requesting approval to pay from DM Client Partners, liaising with Finance to ensure payments are processed. Inputs above data into WHITE database.
5. Collaborates with the Disability Management Client Partner to effectively manage ADM cases by compiling and monitoring reports on the status of Attendance Support services, Direct Referral services and LTD claims, liaising with Managers/Supervisors, Payroll and Benefits and GWL as required.
6. Compiles, analyses and maintains statistical data; produces and distributes summaries and reports as required; receives correspondence from external parties such as service providers and GWL, and enters relevant information into appropriate database.
7. Performs a variety of administrative duties such as preparing correspondence, reports, policies/procedures, minutes, charts and graphs using various software programs.
8. Initiates and maintains efficient manual and electronic filing systems to fulfill required needs.

Diploma in Human Resource Management or equivalent, supplemented by word processing, database and spreadsheet courses and training in claims management plus two (2) years recent related experience in a large multi-union environment, or an equivalent combination of education,and experience.

Demonstrates the leadership practices of the Fraser Health Leadership Framework of Clear, Caring and Courageous and creates the conditions for people to succeed.

Professional/Technical Capabilities

• Knowledge of claims and case management human resource practices and relevant collective agreements.
• Demonstrated ability to effectively deal with staff, third party providers and the general public
• Ability to type at 65 wpm
• Ability to operate related equipment including applicable software applications
• Physical ability to perform the duties of the position