About the Workers’ Compensation Board of Nova Scotia
The Workers’ Compensation Board of Nova Scotia (WCB) is the province’s provider of workplace injury insurance. We inform and inspire Nova Scotians in the prevention of workplace injury. But if it occurs, we support those whose lives it touches by championing a timely return to safe and healthy work. We also provide caring, compassionate support in the wake of workplace tragedy. Our employees describe the culture as Collaborative, Evolving, Service-Minded and Team-Focused.
About the Role
The Eligibility Specialist is responsible for adjudicating medium and complex claims. The Eligibility Specialist manages a caseload of entitlement decisions and proactively collects and reviews information to determine claim eligibility, status, and entitlement. The Eligibility Specialist provides exemplary and compassionate service to all clients, ensures that all adjudication is fair and impartial and promotes trusting relationships in the workplace.
The Eligibility Specialist will be responsible for:
- Investigating the root-cause of claim incidences by following the methodical procedures to collect evidence, interview witnesses, gather statements, review organizational policies and other relevant documentation.
- Conducting in-depth analysis, including the interpretation of conflicting and unfamiliar information, and liaising with healthcare providers, workers, employers, coworkers, agencies, union and lawyer representatives where needed.
- Liaise with external service providers as required to collect and analyze reports.
- Ensuring that adjudication is fair and impartial and fosters professional working relationships.
- Making claim decisions and communicating claim decisions/ rationale to workers, employers, and their representatives.
- Handling requests for claim reconsideration and arranging next steps to process any objections or appeals required.
- Directing accepted claims to Case Managers for overall case management services that will include arranging treatments, timely and safe return to work planning, and overall goals for claim resolution.
Your Experience & Skills
- University degree in healthcare, education, or social sciences
- 4 years' experience performing medium or complex case management in a decision-making capacity in patientcare, social service, health care, insurance, disability case management, or related environment, or applying law and/or policy to make complex determinations.
- Prior experience in investigative work is preferred.
- Access to a vehicle is a requirement for this position.
The WCB Nova Scotia is the province’s provider of workplace injury insurance. Our people are safety champions with a caring, compassionate and can-do-attitude. At the WCB Nova Scotia, every employee is an important contributor to our organization’s corporate goals. We strive to advance our inclusive workplace culture by weaving the social, cultural, visible, and invisible differences of our employees into our way of work. We also take inspiration from the diverse communities we serve across Nova Scotia.
We have adopted a foundational Inclusive Workplace Policy that strives to build upon our core values of safety, care and compassion. We stay in practice to increase our cultural competency and strengthen our relationships with community.
The WCB Nova Scotia is committed to an inclusive recruitment process and workplace that is accessible and accommodating to individuals with disabilities and other protected characteristics to support their full participation in the recruitment process and workplace.
Accommodation Request
WCB Nova Scotia is an equal opportunity employer that is committed to working with job candidates and employees to request reasonable accommodation in a confidential manner.
To request accommodation, please contact the Human Resource team by email at hrdept@wcb.ns.ca. All information received will be kept confidential