Claims Service Representative (7:55 a.m.- 4:30 p.m.)

Early Shift : (7 : 55 : 30 )

Up to 6 Permanent Positions

Acts as the primary point of contact for responding to and resolving claim and coverage related telephone inquiries from workers, employers, representatives, healthcare practitioners, and other service providers received in the Claims Service Centre or when Adjudicators or Case Managers are not available.

Job Duties :

The Claims Service Representative is responsible for creating new claim files, ensuring Workers Compensation coverage, accepting specific no time loss claims, and managing each inquiry to a resolution that provides for customer satisfaction and meets organizational standards and objectives.

Uses effective listening and questioning techniques to determine each customer's need(s); identifies, evaluates and determines alternatives to problem solve.

When unable to resolve an inquiry prior to the end of the call, takes steps necessary for resolution immediately following the call or arranges for an Adjudicator or Case Manager to resolve on a timely basis.

Follows established procedures to create new claim files, input data, search the database, and verify and collect information by calling for, or requesting reports from injured workers, employers and healthcare providers.

Notifies the appropriate internal parties at time of reporting of a serious accident or fatality.

Follows department standards for gathering, reviewing, and assessing information to establish Workers Compensation coverage for new claims, communicating decisions to affected parties where appropriate, and referring to the Supervisor or Assessment Services in cases where further action is necessary.

Accepts no time loss claims (Complexity A) within defined parameters. Claims requiring further investigation or approval are forwarded to Adjudicators for review.

Utilizes each inquiry as an opportunity to address customer concern(s) and anticipate future needs, reviewing outstanding or future claim file tasks when appropriate.

Identifies workers in crisis and refers to an appropriate WCB resource.

Reviews the claim file and approves medical expenses within specified guidelines and authority levels. Manages claim owner approved wage loss issues.

Refers inquiries that are highly unusual, complex or above authority levels to the appropriate Adjudicator or Case Manager.

Updates claim files as part of each call; clearly documents customer communication including any information gathered, entitlement decisions made, actions taken and claim tasks created.

Provides coverage at the main reception desk.

Completes statistical coding of claims within quality and timeliness standards.

Performs other related duties as assigned.

Qualifications :

Completion of a two (2) year diploma in a related discipline (Business Administration)

Minimum two (2) years' experience interpreting and applying processes and procedures to manage and resolve customer inquiries / concerns

Typing speed of 35 (error rate less than 5%)

Knowledge of customer service principles and practices

Proficiency in the use of personal computers and software in a Windows environment

Excellent customer service skills including the ability to manage potentially confrontational situations with tact and diplomacy

Well-developed verbal and written communication skills to deal with internal and external stakeholders

Ability to interpret and apply processes and procedures including those related to WCB Adjudication and Case Management

Ability to obtain, assess and evaluate information through claim file review, listening and / or questioning in order to problem solve and support decision making

Ability to perform detailed and accurate work in a fast paced environment

Ability to work independently and as part of a team

Customer service experience in a call centre environment including knowledge of call centre telephony and technology would be an asset

Knowledge of advanced communication skills such as active listening and de-escalation techniques would be an asset

Additional Information :

Salary Range : $55,684 - $69,603

The Claims Service Representative (CSR) is an introductory position that provides the knowledge and experience necessary to move into a variety of different roles within the WCB.

The WCB believes strongly in career development and promoting from within, and a significant number of CSRs begin their WCB career in this role.

Join one of Manitoba's Top 100 employers to advance your career.

Please note that this position will begin on January 8, 2024 with an 8 week training class. During the training period, you will not be eligible to take vacation and the hours of work will be Monday to Friday, 8 : 30 : 30 , Regular scheduled hours of work are Monday to Friday, 7 : 55 : 30 , you will receive an additional day off (ADO) in each bi-weekly pay period which does not include a statutory holiday.

A satisfactory criminal record check and verification of education will be required for the successful candidate.

The WCB is committed to building a skilled, diverse workforce with equitable representation of Indigenous persons, visible minorities, persons with disabilities, women, LGBTTSQ+ persons and members of other equity-seeking groups.

Applicants are encouraged to indicate in their covering letter or resumé if they are a member of these groups.

The WCB recognizes that individuals may face barriers that hinder their full and equal participation in the workplace, and is committed to providing reasonable accommodation to all employees and candidates who are or may be disabled by one or more barriers in the workplace.

Accommodations are available on request for candidates taking part in all aspects of the selection process.

ABOUT WCB :

The Workers Compensation Board promotes safety and health in Manitoba workplaces and aims to help prevent and reduce the occurrence of workplace injuries and disease.

Working with its partners, the WCB promotes safe and healthy workplaces, facilitates recovery and return to work, provides compassionate and supportive compensation services for workers and employers, and ensures responsible financial stewardship.

WCBdoes encompasses what it means to work at the WCB. The WCB is proud to have employee benefits and programs that support financial and personal security, foster health and well-being, encourage involvement and support growth as an individual and member of the WCB community.

The four categories of WCBdoes include : Security, Wellness, Engagement and Growth.

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