With a vision to become the leading workplace compensation board, the Workplace Safety and Insurance Board (WSIB) provide no-fault insurance and compensation for Ontarians in the event of a workplace injury or illness. We are committed to delivering what matters: fast, accessible service and fair benefits at a fair price.
We've recently launched a comprehensive plan for modernizing and revitalizing the WSIB. This is an exciting time for the organization, and we invite you to be a part of it as we work to grow and improve the services we provide.
Recognized as a best-in-class learning organization, we promote professional development and are committed to providing our people with opportunities to lead, learn and grow, ensuring that we're providing the best possible service to the people of Ontario. We offer a market-competitive total compensation plan and a robust wellness program that promotes a healthy lifestyle as well as work/life balance.
The work we do at the WSIB is meaningful and challenging, and it makes a difference to the people of Ontario. We value integrity, reliability and fairness, and we embrace the diversity of the people we work with and serve.
Eligibility Adjudicator
Permanent Vacancy
Recruiting for future opportunities (unilingual and bilingual)
*Toronto *Hamilton *Ottawa *Thunder Bay *Sudbury *Windsor *Kitchener *LondonThe number of vacancies for this position has not been determined at this time. The current recruitment will be used to create a pool of qualified candidates to fill upcoming opportunities within the next eighteen months.
There is a mandatory training period required of this position, which is anticipated to extend up to 18 weeks, comprising of a combination of in-class training and practicum, with no scheduled vacation breaks.
About the job
Eligibility Adjudicators in many cases may be the workplace parties' first point of contact and will create a positive first impression by acknowledging the injury, collecting relevant information required to make timely and well communicated quality decisions that enable workers to achieve the best possible return to work and recovery outcomes.
Working in a fast-paced, service oriented environment, Eligibility Adjudicators use a proactive case management approach to make and communicate eligibility decisions in a timely and consistent fashion. This includes decisions on benefits and services and the areas of injury allowed. They provide basic information to workplace parties who are demonstrating self-sufficiency in recovery and return-to-work.
Eligibility Adjudicators address worker and employer needs by actively listening, collecting and providing relevant information, and helping the workplace parties understand their rights, responsibilities and obligations. Following a structured case management framework will enable Eligibility Adjudicators to achieve high quality outcomes and success with eligibility decisions.
What you bring to the team
Major Responsibilities
Inform parties of their rights, responsibilities and obligations under the WSI Act and applicable legislation, and the consequences of non-compliance.
• Proactively collect and document relevant information from workplace parties and healthcare providers required for eligibility decisions and respond to inquiries.
• Assess case and plan towards best outcomes. Make timely and accurate eligibility decisions and communicate them, verbally and in writing.
• Support workplace parties in their return to work (RTW) efforts by sharing any available information about the workers' capabilities and/or precautions.
• 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.
• Identify and refer cases to appropriate internal WSIB parties (Payment Specialist, 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.
• Perform other related duties as assigned or required such as participation in the development and implementation of business plans and projects.
Professional Qualifications
• Strong analytical, problem solving, critical thinking and decision making skills in order to assess complex information and make timely decisions with a strong sense of urgency
• Successful completion of university degree
• 2-3 years of related work experience is preferred
• Knowledge of and experience in a fast-paced, high volume, service oriented environment
• Results-driven approach and excellent customer service includes strong communication and active listening skills, effective negotiation, influencing and dispute-resolution abilities
• Achievement orientation and strong organizational and time management skills that allows you to effectively work under pressure in a high volume environment
• Ability to work independently and as part of a team is essential as is experience composing complex written documentation
• Computer literacy in Windows, MS Office and Lotus Notes
What we offer you in return
As a precondition of employment, the Workplace Safety & Insurance Board will require a prospective candidate to undergo a criminal record check prior to hire.
How to apply
To apply, visit our Job Opportunities page:
https://www.wsib.on.ca/WSIBPortal/faces/WSIBArticlePage?fGUID=835502100635000719/