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In-Scope

Multiple Positions

• Permanent

• Temporary (6–12-month terms)

Work Location: These positions may be located at any Saskatchewan Branch location (subject to desk availability in the branch) and are eligible for hybrid work – this means you’ll have the flexibility of working from home and in the office, on a scheduled rotation once training requirements have been met. Until then, the successful incumbent will be expected to work on-site, full-time.

GENERAL ACCOUNTABILITY

The Personal Injury Representative I is responsible for monitoring, evaluating, and coordinating benefits under No Fault Injury Benefits for less complex injury claims. The incumbent focuses on early intervention, through rehabilitation, to help injured persons return to their pre-accident status.

KEY ACCOUNTABILITIES

Note: This section is not intended to be an exhaustive list of duties and responsibilities – other duties and responsibilities may be assigned.

• Interviews injured person(s), individually or with family members, to assess the situation, to complete Application for Benefits, and to determine No Fault Injury Benefits coverage entitlement and validity of claim, as determined through interpretation of the AAIA (Automobile Accident Insurance Act), policy wordings, and other related acts and regulations.

• Approves and monitors rehabilitation plans based on medical and psychosocial information obtained, and/or in consultation with treating practitioners.

• Evaluates and assesses injury claims based on medical and psychosocial information and formulates benefits based on these assessments.

• Gathers and analyzes employment-related information necessary to calculate Income Replacement Benefits.

• Responds to questions and correspondence from the injured person(s), treating practitioners and/or other interested parties regarding the current status of recovery and benefits.

• Interviews injured person(s) to evaluate the progress of their recovery, to ensure that the terms specified in the treatment plans are being maintained, and to ensure that the claim proceeds to secondary and/or tertiary levels as required.

• Gathers medical information relating to the injured person's permanent impairment and forwards to the Medical Consultant for assessment.

• Explains coverages, benefits, breaches of condition, exclusions, and termination of benefits to injured person(s), their families and/or other interested parties as required.

• Coordinates the injured person's recovery by investigating need and approving funds for medical rehabilitation services and equipment and submits for approval as required.

• Maintains ongoing contact with the injured person(s) and/or family to ensure an understanding of their role in the claims process.

• Sets up claim files, confirms coverages, establishes, and adjusts reserves and completes all necessary reporting forms and documents.

• Obtains medical information to substantiate claim by disbursing all necessary forms and documents to practitioners and/or caregivers involved.

• Participates in meetings and/or interviews with SGI personnel, treating practitioners, witnesses, legal representatives and/or other external persons as required.

• Participates in group meetings that focus on improving processes, may contain training elements and review of services. Recommends approval and/or denial and prepares claims for mediation, appeal and/or action by other personnel.

• Identifies the possibility of subrogation, takes the appropriate action, and ensures the claim file is properly documented.

• Determines replacement coverage of customers’ articles.

High Performance Team & Culture

• Supports a culture of leadership and accountability to effectively meet the key accountabilities within the scope of the role.

• Displays leadership by committing to a culture of continuous learning/development of self and supports others by actively sharing knowledge, providing guidance, mentoring, training, and supporting developmental opportunities.

• Demonstrates that the Health, Safety and Emergency Management Policy is applied in area of responsibility for self and others.

• Actively applies knowledge to support transformation and strategic initiatives of the corporation, while participating and advocating change and applying a growth mindset.

TECHNICAL KNOWLEDGE & SKILLS

• Knowledge of the insurance coverages and benefits provided by the AAIA and/or general business policy wordings.

• Knowledge and understanding of the terminology and treatments involved in vocational and medical rehabilitation.

• Knowledge of the processes and procedures as they relate to case management and the adjustment of No-Fault claims.

EDUCATION & CERTIFICATIONS

• Two-year diploma from an accredited post-secondary institution in a relevant field of study such as Social Sciences or Health, or defined equivalency.

• Possess a valid operator's licence in positions where required.

EXPERIENCE

• 1 – 3 years’ experience in in an insurance or customer service role in a health-related field.

Leader Level 2 – Applies (Self & Others)

• Accountability - Goes Beyond Basic Expectations to Implement Customer/Partner Focused Solutions

• Business Acumen - Applies Business Fundamentals and Thinks in Future-Oriented Terms

• Change Agility - Is Nimble; Shifts Gears Quickly and Comfortably

• Leadership - Leads Self and Others

Diversity is a cornerstone of SGI. We believe all candidates should be given the opportunity to fully participate during the recruitment process. If you require an accommodation during the recruitment process, we invite you to submit your accommodation requests to us at wellness@sgi.sk.ca and we will work through your request with you. All information received will be kept confidential.

Posting Close Date:

As you prepare to submit your application, and cover letter if applicable, please highlight the achievements that demonstrate why you're a great candidate for this role.