Claims Entitlement Specialist II en Saskatchewan Workers' Compensation Board
Saskatchewan Workers' Compensation Board · Regina, Canadá · Onsite
- Professional
- Oficina en Regina
Claims Entitlement Specialist II
Permanent Appointment
Regina Head Office
Job Summary:
Determines claim acceptability and entitlement to benefits under the Workers’ Compensation Act. Initiates, implements and monitors Return to Work Programs for injured workers. Gathers information and responds to inquiries. Communicates decisions to injured workers, employers, their representatives, and caregivers as it relates to the claim.
Duties & Responsibilities:
Determines claim acceptability (for time loss and no time loss claims) and entitlement to wage loss and medical benefits on the initial injury claims where the cause and effect relationship is straight-forward to more complex and requires a moderate level of time, skill, and effort. Reviews the information received, gathers additional information from all stakeholders and applies legislation, policy and procedures
Contacts parties to ensure that all parties understand the process and the necessary information is required from them to resolve claim.
Initiates, implements and monitors early Return to Work Programs for injured workers by coordinating with workers, employers and health care providers (for time loss and no time loss claims)
Determines and gathers appropriate wage base information from employers and/or workers by telephone.
Directs Payment Coordinator on FEL loss date, authorizes full and partial wage loss pay via the dates in Eclipse or through related memo documentation and instructs if the claim should be closed or referred to Case Management.
Ensures that authorizations are made for travel expenses, prescription and other entitlements according to legislation, policy and procedure.
Determines ongoing entitlements and case management of Time loss and No time loss claims, by monitoring the progress of the injured worker’s recovery prior to referral to Case Management.
Identifies the need for secondary assessments, specialist referrals, MRI and other diagnostic specialized testing. Initiates referrals to other areas when and where appropriate.
Responds to stakeholder inquiries. Obtains, communicates and records information provided by injured workers, employers, health care providers, etc. in person, by telephone or through written correspondence. May need to handle negative and/or hostile reactions.
Authorizes the creation of overpayment of benefits. Sends out initial letter for collections of overpayment.
Determines if a claim is eligible for cost relief and documents this through a cost relief memo and forwards written correspondence to the employer of the decision.
Qualifications:
Two (2) years successfully completed post-secondary education in business, health care, education or social sciences plus one (1) year of successful experience providing direct customer service demonstrating the ability to:
Apply knowledge of acts/regulations or policies in decision-making
Organize work efficiently
Set priorities appropriately
Complete work within established time frames
Effectively communicate orally and in writing
Problem solve
Make sound decisions with minimal supervision
Application Deadline: October 5, 2025
Applications:
It is the responsibility of the applicant to ensure that the application is received through the online application system prior to close. Each application must include a cover letter explaining how each qualification is met and an updated resume.
The Saskatchewan Workers' Compensation Board is committed to achieving a representative workforce. Members of designated groups (women, aboriginal people, people with disabilities and visible minorities) are encouraged to apply.
