Benefits Administrator

Job Description:

Benefits Administrator

FULL-TIME TEMPORARY POSITION

(1 year with possible extension)

The Workers Compensation Board (WCB) helps to build safe and healthy workplaces in PEI and provides benefits and services to reduce the impact of work-related injuries.

The Benefits Administrator is primarily responsible for assisting in the appropriate management of workflow by managing incoming claim information and administering, adjudicating, redirecting, or assigning as appropriate.  This position is responsible for a number of activities related to claim administration and claim management.  The Benefits Administrator is required to follow legislation, policy and procedure, guidelines and work practices and is expected to use judgement in the listed job duties.

The Benefits Administrator reports to the Supervisor, Long Term Benefits.

Duties include, but are not limited to:

• Assisting in the management of workflow by reviewing incoming claim information and administering, adjudicating, redirecting, or assigning claims as appropriate.
• Determining the optimum route for claims, using a set of business rules.
• Using established guidelines to authorize assessments and treatment as appropriate.
• Interpreting applicable legislation and policy to determine entitlement to medical aid benefits.
• Participating in the management of Extended Wage Loss and Health Care Benefit claims.
• Managing claims in which the worker is either awaiting or awarded an impairment award.
• Managing inactive claims in which new information has been submitted to determine entitlement to further benefits and claims for workers who have returned to work but require ongoing medical aid benefits.
• Managing Extended Wage Loss claims to determine entitlement to health care benefits.
• Responding to client calls and walk-ins as necessary and drafting authorization correspondence.

Qualifications:

Applicants must possess a university degree or two-year college diploma, with major course work in business administration, accounting technology, public administration, or office administration.  Experience in a responsible position demonstrating the applicant’s decision-making abilities, application of policy and legislation, analytical, logical, and critical thinking skills is required.  Demonstrated proficiency in the use of Microsoft Office Suite of products.

• Applicants must have strong organizational and communication skills.
• Experience managing a client caseload and having a good understanding of medical terminology is an asset.
• Demonstrated equivalencies will be considered and must be articulated in the application process.
• Bilingual in both French and English would be considered an asset.
• A satisfactory criminal records check is required for this position.

The Workers Compensation Board is committed to providing a safe, healthy and inclusive work environment for all employees and offers hybrid opportunities for remote work based on the operational needs of the position.

Although we sincerely appreciate the interest of all applicants, only those selected for an interview will be contacted

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