Disability Specialist - Quality Assurance

Group Life & Disability  Waterloo, ON

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 forthe work they do, supportedasthe people they are, and included in thevery fabric of the organization: they bringtheirbestto work every day. And that's why we mean itwhen wesay we put our people at the centreofeverything we do. Join us as we grow our way into a future that reimagines what it means to deliver meaningful benefits support and service.

What You’ll Do:

Reporting to the Group Life and Disability Claims - Quality Assurance Team Manager you’ll be responsible for conducting comprehensive quality assurance reviews for Group Life and Disability Claims (GL&DC) and LTD Services. This includes evaluating technical and system processes, contractual case management, and call observations. These reviews will be performed in alignment with the department's established contractual and administrative policies. The role also involves clearly communicating the results of these reviews to GL&DC staff, both verbally and in writing.

Additionally, the Disability Specialist will participate as a member of the Appeal Committee as needed.

The core parts of your role will be to:

• Works as a member of the Group Life and Disability Claims Quality Assurance team to conduct regular quality assurance audits of GL&DC staff as assigned in an efficient manner.
• Completes quality assurance reviews and provides results of technical, case management and call observation audits in accordance with contractual and administrative policies established within the GL&DC department.
• Deliver timely quality assurance reviews.
• Effectively communicates quality assurance results and maintains confidentiality related to an individual’s audit results.
• Liaises with the training team to identify trends, best practices, and training needs, ensuring training and development initiatives are aligned with audit findings and organizational objectives.
• Works closely with the GL&DC management team related to an individual’s results or to change the audit review focus as needed to meet the changing requirements of GL&DC business needs.
• Acts as a senior resource to GL&DC claims employees and managers. This may include providing input on complex claim situations, contractual interpretation and assigned projects.
• Maintains technical knowledge by attending educational workshops, reviewing publications.
• Supports change within GL&DC and works effectively in a team environment and contributes to overall team goals and workload management.
• The Disability Specialist will intermittently represent the claims business area as part of the Appeal Committee where they will be required to review appeal claims and discuss the case with other appeal committee members to render a final appeal decision.
• Performs other duties with competence, as assigned.

Let’s Talk About You:

This is the unique blend of skills and experience we would love to see in an ideal candidate:

Qualifications:

• A university degree or college diploma in a related subject.
• A minimum of five years’ experience in long-term disability claims adjudication in the insurance field.
• Strong knowledge related to long term disability claims management and 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.
  
  Working Conditions:
• May be required to work overtime.

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…