Case Manager

You play a senior role on the Assistance Team by participating in the provision of 24-hour assistance service for incoming calls regarding claims-related medical emergencies, as well as providing key administrative functions.  You triage each emergency situation with care and urgency, making decisions and multi-tasking. You are a customer-focused, pro-active problem-solver who thinks ahead, can shift priorities quickly, and has amazing attention to detail.

Responsibilities:

• Participate in the provision of 24-hour emergency medical and non-medical support to our clients and their families. Support includes: collecting information and contacting family members/hospitals with updates, making key decisions in determining the logistics for medical evacuations – both ground and air, facilitating commercial flight arrangements.
• Provide leadership and guidance in addition to hands-on support. This includes delegating work effectively.
• Conduct daily medical monitoring of hospitalized patients and acts as the liaison between the client and all other parties (facility, physicians, family etc.).
• Initiate claims by verifying client’s policies and coverage.  Open new claims in database and set initial reserves.
• Participate in reporting of hospitalizations statistics and monthly reserves.
• Contact health networks, enter data into our system, and research network affiliations for billing information.
• Conduct a variety of research including sourcing quotes and logistical information for flight times and ambulances. Verify discounts, monitor costs and update reserves.
• When possible, assist with clerical functions.
• Achieve performance targets.
• Collaborate and communicate effectively with team members and all other teams.
• Responsively and effectively handle stressful issues.
• Other duties as required.

• Degree or diploma in business or medical related field
• 7+ years of progressive experience in customer service, preferably a contact centre providing emergency assistance
• Previous case management experience
• Previous leadership experience and the ability to delegate effectively
• Ability to assist clients in stressful situations over the phone
• Ability to quickly change priorities
• Demonstrated initiative and the ability to make good decisions under pressure
• Ability to speak/read French and/or Spanish an asset
• Well-developed analytical, problem-solving, and decision-making skills
• Ability to learn and apply knowledge of insurance policy wordings to assistance work
• Familiarity with Medical terminology
• Must be able to work flexible hours (early morning, afternoon, evening, night, weekend, and holiday shifts)
• Excellent written and verbal English communication skills
• Strong team player and positive contributor
• Proficient in MS Office Suite and able to learn applications quickly
• A passion for continuous learning and professional achievement
• A passion for travel