Talent Pool - Eligibility Adjudicator - Jobs in Toronto, ON

Job Description

Our priority is the health and wellness of employees and the people of Ontario. As such, this position may involve working from home for part of the duration of this position. The WSIB model mixes working from home, office and field.About the Workplace Safety and Insurance Board (WSIB)Were here to help. When an injury or illness happens on the job, we move quickly to provide wage-loss benefits, medical coverage and support to help people get back to work. Funded by businesses, we also provide no-fault collective liability insurance and access to industry-specific health and safety information. We are one of the largest insurance organizations in North America covering over five million people in more than 300,000 workplaces across Ontario. For more information, visit wsib.ca.At the WSIB, youll have the opportunity to:

• explore many career paths and follow your passion
• continuously learn and grow professionally
• be recognized for the great work you do
• participate in programs that support your health and wellbeing

Youll also receive a competitive salary, along with a comprehensive benefit package and defined benefit pension plan.The WSIB is recruiting for current and future unilingual and bilingual (French speaking) opportunities in the following locations:Guelph, Hamilton, Kingston, Kitchener, London, North Bay, Ottawa, Windsor, Sault Ste. Marie, Sudbury, Thunder Bay, Toronto, Timmins & WindsorThere may be a requirement to work 9:15am to 5:15pmSalary: $74,740.50OPS Commitment to Diversity, Inclusion, Accessibility, and Anti-Racism:We are committed to build a workforce that reflects the communities we serve and to promote a diverse, anti-racist, inclusive, accessible, merit-based, respectful and equitable workplace.We invite all interested individuals to apply and encourage applications from people with disabilities, Indigenous, Black, and racialized individuals, as well as people from a diversity of ethnic and cultural origins, sexual orientations, gender identities and expressions.Visit the OPS Anti-Racism Policy and the OPS Diversity and Inclusion Blueprint pages to learn more about the OPS commitment to advance racial equity, accessibility, diversity, and inclusion in the public service.We offer employment accommodation across the recruitment process and all aspects of employment consistent with the requirements of Ontarios Human Rights Code. Refer to the "How to apply" section if you require a disability-related accommodation.What can I expect to do in this roleUse a proactive case management approach to make and communicate eligibility decision on benefits and services in a timely fashion that are consistent with relevant WSIB policy. Address worker and employer needs by actively listening, collecting and proving relevant information, and helping the workplace parties understand their rights, responsibilities and obligations.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.How do I qualifyMajor Responsibilities:1. Inform parties of their rights, responsibilities and obligations under the WSI Act and applicable legislation, and the consequences of non-compliance.2. Proactively collect information from workplace parties and healthcare providers required for eligibility decisions and respond to inquiries.3. Assess case and plan towards best outcomes. Make eligibility decisions quickly and accurately and communicate them, verbally and in writing by determining the following:

• The employer is covered under the Act;
• The worker is employed by the employer at the time of the injury;
• The injury is work-related;
• Proof of accident can be established;
• The diagnosis is compatible with the accident;
• Continuity and compatibility support ongoing entitlement in the case of recurrence;
• Ensuring accident reporting compliance with the employer.

4. Support workplace parties in their return to work (RTW) efforts by sharing any available information about the workers capabilities and/or precautions.5. 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.6. Review and monitor cases until closure or transition to a Case Manager, assessing RTW and recovery factors to differentiate cases requiring Case Manager expertise.7. Refer requests to appropriate internal WSIB parties (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.8. Attempt to prevent or resolve disputes, handle requests for reconsideration and, if unresolved, arrange access and process the objection.9. Perform other related duties as assigned or required such as participation in the development and implementation of business plans and projects.Job Requirements:Education

• University completion at undergraduate level.

Experience

• Two years prior experience in adjudication and customer service.

Application Instructions:As a precondition of employment, the WSIB will require a prospective candidate to undergo a criminal records name check prior to or at any time following hire.To apply for this position, please submit your application by October 28, 2022 at 11:59 PM via website: https://www.wsib.ca/en/careersWe appreciate the interest of all candidates. Due to the volumes of applications we receive, we are only able to contact candidates that are selected to move forward in the recruitment process. The WSIB is an equal opportunity employer.Additional Information:The WSIB is an equal opportunity employer and provides accommodation for job applicants in accordance with the Human Rights Code and the Accessibility for Ontarians with Disabilities Act. If you are an individual with a disability and you need accommodation in order to apply for this position, please contact talentacquisitioncentre@wsib.on.ca. If you are invited to participate in the assessment process, please provide your accommodation needs at that time.Please be advised that you may be required to provide medical documentation to the WSIBs Corporate Health Department so that appropriate accommodation can be provided to you throughout the recruitment process.Employees of the WSIB have important ethical responsibilities, including the obligation to place the public interest above personal interests. Job applicants are therefore required to disclose any circumstance that could result in a real, potential or perceived conflict of interest. These may include: political activity, directorship or other outside employment and certain personal relationships (e.g. with existing WSIB employees, clients and/or stakeholders). Please contact TAC if you have any questions about conflict of interest obligations and/ or how to make a disclosure.Privacy informationPersonal information will be collected from your resume, application, cover letter and references under the authority of the Workplace Safety and Insurance Act, 1997 and will be used by the Talent Acquisition Centre and WSIB hiring parties to assess/validate your qualifications and/or determine if you meet the requirements of vacant positions and/or gather information relevant for recruitment purposes. If you have questions or concerns regarding the collection and use of your personal information, contact the WSIB Privacy Office, 200 Front Street West, Toronto, ON, M5V 3J1 or 416-344-5323 or 1-800-387-0750 extension 5323. Be advised that information related to application status will not be provided.Additional Information:Address:

• 1 Permanent, 200 Front St W, Toronto, Toronto Region

Compensation Group: ExcludedUnderstanding the job ad - definitionsSchedule: N/ACategory: Health and Social ServicesPosted on: Thursday, October 6, 2022Note:

• This posting is for an organization that is not a part of the Ontario Public Service. The information and tips on the Ontario Public Service Careers website may not apply to this posting. Please use the contact information below to contact the organization directly if you have questions.

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