Eligibility Adjudicator

Job Description:

Manage cases that are allowed, denied, reconsidered or resolved within established program guidelines, following a structured case management framework to enable them to achieve high quality eligibility decisions and successful outcomes.

Job Responsibilities:

• The employer is covered under the Act
• Inform parties of their rights, responsibilities and obligations under the WSI Act and applicable legislation, and the consequences of non-compliance.
• The diagnosis is compatible with the accident;
• Support workplace parties in their return to work (RTW) efforts by sharing any available information about the workers’ capabilities and/or precautions.
• With the assistance of Payment Specialists where required, ensure appropriate earnings information is on file in order to determine the appropriate duration and level of benefits.
• Continuity and compatibility support ongoing entitlement in the case of recurrence;
• Ensuring accident reporting compliance with the employer.
• Proactively collect information from workplace parties and healthcare providers required for eligibility decisions and respond to inquiries.
• Assess case and plan towards best outcomes. Make eligibility decisions quickly and accurately and communicate them, verbally and in writing by determining the following:

Job Requirements:

• University completion at undergraduate level.
• Two years prior experience in adjudication and customer service.

Job Details:

Company: Workplace Safety and Insurance Board

Job Category: Government

Vacancy Type: Full Time

Job Location: Hamilton, Ontario, CA

Application Deadline: N/A

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