Eligibility Adjudicator, Service Delivery - Amended

With a vision to become the leading workplace compensation board, the Workplace Safety and Insurance Board (WSIB) provides 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.

The WSIB's Service Delivery Division is a key partner in the organization's strategic transformation initiatives with a focus providing better service to the employers and workers of Ontario.

Eligibility Adjudicators, in many cases, may be the first point of contact for workplace parties. Charged with creating a positive first impression in what are often sensitive circumstances by acknowledging the injury, collecting relevant information required to make timely and well communicated quality decisions by telephone and in writing to enable workers to achieve the best possible return to work and recovery outcomes. Eligibility Adjudicators make decisions regarding benefits and services in the areas of entitlement accepted as work-related.

We are looking for service-oriented, proactive, and results-oriented professionals to work in a fast-paced environment, to use a proactive case management approach to make and communicate eligibility decisions in a timely and consistent fashion. Providing basic information to workplace parties in recovery and return-to-work, address worker and employer needs by actively listening, collecting and providing relevant information, and helping the workplace parties understand their rights, responsibilities and obligations.

What can I expect to do in this role?

• 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.

How do I qualify?

Knowledge and Skills

• Bachelor's degree (minimum)
• Knowledge and experience, relevant adjudication and customer service experience within a fast-paced, high-volume environment involving negotiation and dispute-resolution.
• Demonstrated critical thinking, problem solving, decision-making, and analytical skills to assess complex information and render timely decisions with a strong sense of urgency.
• Superior writing skills to prepare complex written correspondence to workplace parties outlining claims decisions
• Strong communication and interpersonal skills with the ability to negotiate and work with workplace parties to gather information required for decision-making as well as communicate eligibility decisions.
• Results-driven approach and strong time management skills to effectively work under pressure in a high-volume environment
• Proficiency with Windows and MS Office programs
The WSIB offers a comprehensive training program for the Eligibility Adjudicator position, which involves 9 weeks of in-class training, followed by 8-10 weeks of practicum at your home office location. During the practicum, the direct Manager will work closely with the trainee and provide on-going developmental feedback in a learning environment. Attendance and completion of the full training program is a mandatory requirement and therefore we require full commitment and attendance during this period. As part of the practicum, your performance will be closely monitored and reviewed and you will be required to achieve the Eligibility Adjudicator Performance objectives set out as part of the training program.

Note: As a precondition of employment, the Workplace Safety & Insurance Board will require a prospective candidate to undergo a criminal record check prior to hire.

Note: 'We are recruiting for future opportunities in the following offices, Toronto, Windsor, Sudbury, Kitchener, London, Hamilton, Ottawa and Thunder Bay'

Note: To apply for this position, please submit your resume and covering letter through our website, www.wsib.on.ca or through LinkedIn

Collection of Information

Your personal information is being collected and will be used to determine your qualifications for employment with the Ontario Public Service, and for recruitment modernization initiatives. OPS Careers is an authorized common service in accordance with s. 6 of the Ministry of Government Services Act, R.S.O. 1990, c. M.25 and this collection of personal information is necessary to the proper administration of OPS Careers.

Please do not provide more personal information than what is asked of you. For example, do not include your social insurance number, photograph, or banking information, etc. with your application. We strongly encourage you not to provide us with information beyond that which is requested in the job posting.

If you have any questions about the collection, use, disclosure, or retention of your personal information, please contact us.

All external applicants (including former employees of the Ontario Public Service) applying to a competition in a ministry or Commission public body must disclose (either in the cover letter or resume) previous employment with the Ontario Public Service. Disclosure must include positions held, dates of employment and any active restrictions as applicable from being rehired by the Ontario Public Service. Active restrictions can include time and/or ministry-specific restrictions currently in force, and may preclude a former employee from being offered a position with the Ontario Public Service for a specific time period (e.g. one year), or from being offered a position with a specific ministry (either for a pre-determined time period or indefinitely). The circumstances around an employee's exit will be considered prior to an offer of employment.

Remember: The deadline to apply is Friday, November 29, 2013 11:59 pm EST. Late applications will not be accepted.

We thank you for your interest. Only those selected for further screening or an interview will be contacted.