Altis Recruitment is seeking a Claims Adjudicator for our public sector client to manage short-term disability (STD) and WSIB claims. This position involves overseeing the end-to-end claims process, from intake and adjudication to reporting and communication, with the goal of ensuring timely, accurate, and compliant administration of all claims.

The ideal candidate brings a strong background in disability claims administration, familiarity with WSIB processes, and a proactive approach to stakeholder communication and case management.

Roles and Responsibilities

• Administer WSIB claims including timely completion and submission of Form 7, wage details, and return-to-work documentation
• Adjudicate and process STD, salary continuance, and advance payments in accordance with organizational policies and procedures
• Liaise with injured employees, managers, union representatives, and external parties to gather claim information and confirm status updates
• Ensure claims files are well documented, current, and aligned with PHIPA privacy standards and internal protocols
• Evaluate claim eligibility using medical information, case history, and disability policy provisions
• Communicate claim decisions to employees and issue formal correspondence as required
• Track claims for timely follow-ups, outstanding documentation, and weekly benefit processing
• Advise on disability accommodation policies and modified work programs in alignment with human rights legislation
• Maintain familiarity with relevant legislation (e.g., WSIA, PHIPA, OHRC) and organizational collective agreements

Qualifications and Skills

• Minimum 2–4 years’ experience in STD and WSIB claims administration, preferably in a unionized or public sector setting
• Strong knowledge of medical terminology, occupational health practices, and return-to-work planning
• Familiarity with relevant privacy and health legislation (PHIPA, Human Rights Code)
• Excellent judgment, analytical skills, and ability to handle sensitive cases with discretion
• Proficient in Microsoft Office and claims management systems; strong data entry and documentation skills
• Ability to manage multiple cases in a high-volume environment with strong attention to detail

Education

• Post-secondary education in Human Resources, Health & Safety, Disability Management, Insurance, or a related field