WSIB Claims Management Advisor

Bayshore HealthCare is one of the Canada’s leading providers of home and community health care services and is a privately owned company. Bayshore HealthCare is proud to showcase its achievement as a Platinum member of Canada’s Best Managed Companies Program every year since 2006. Bayshore Healthcare is also recognized as Canada’s Best Employers in Forbes 2023 list.

Reporting directly to the WSIB Manager, the WSIB Claims Management Advisor will manage workers’ occupational and non-occupational injury or illness, and support stay at work and return to work processes for Ontario.

The role includes submitting initial claim documentation, coordinating with workers and their supervisors, and actively facilitating their safe and timely return to work through personalized return-to-work plans and ongoing communication with all parties involved.

The role will also be responsible for managing claim reports for legitimacy, possible challenges, trends analysis and cost control. This will include working with the WSIB Manager to assist them in their preparation of appeals and complex return to work scenarios and representing Bayshore up to the hearings and appeals tribunal when required.

Key Responsibilities

Claim Submission and Processing:

• Receive and review worker’s occupational claim reports to determine eligibility for WSIB benefits.
• Accurately complete and submit all necessary occupational claim forms and documentation within established timelines.
• Gather medical reports, witness statements, and other relevant information to support claim submissions.
• Follow up on outstanding information to ensure timely claim processing.
  
  

Return To Work Coordination

• Contact workers and supervisors upon receiving a new claim to discuss the return-to-work process.
• Develop individualized return-to-work plans in collaboration with the worker, employer, and healthcare providers.
• Based on the worker's functional abilities, identify potential workplace modified duties or accommodation needed for a safe return to work.
• Monitor the progress of the return-to-work plan and adjust as required.
  
  

Communication And Stakeholder Management

• Maintain open communication with workers, supervisors, healthcare providers, and WSIB case managers throughout the claim process.
• Educate all parties involved on their rights and responsibilities regarding workers' claims.
• Provide training in Claims Management processes as required.
• Address concerns and resolve disputes through effective negotiation and mediation skills.
• Collaborate with the Health and Safety committees and ensure a follow-up with all external partners.
  
  

Claim And Disability Case Management

• Maintain detailed case files, documenting all interactions/correspondence, medical updates, and return-to-work plan progress.
• Participate in case management meetings with the employer and WSIB and others as needed.
• Track claim status and identify potential issues that may impact the return-to-work timeline.
• Conduct regular reviews of active claims to ensure timely and appropriate claim management.
• Participate in claims appeals and complex return to work scenarios and representing Bayshore up to appeal hearings and tribunals.
• Perform other support related duties as required.
  
  

LOCATION

Primarily remote work within Ontario. Preferred locations include the GTA with the expectation to travel to branches within the area of service.

EDUCATION

• University Degree or College Diploma related to Disability Management, Occupational Therapy, Rehabilitation, Human Resources, Legal Studies
• Professional designation preferred such as, but not limited to: Certified Disability Management Professional (CDMP), Certified Return-to-Work Coordinator (CRTWC),
• Chartered Professional in Human Resources Human Resources Certificate, Disability Management Certificate/Diploma, Paralegal
  
  

Experience

• Minimum of 5 years of experience in disability/claims management/occupational health & safety.
• Minimum of three (3) to five (5) years’ work experience in case managing WCB claims including workplace accommodations.
  
  

Primary Location

ON-Mississauga