Nurse overseeing health program visits and patient monitoring within Unimed Porto Alegre. Responsibilities include patient care, auditing, and quality compliance in health services.
About the role
- Senior Claims Advisor managing CNESST cases from administrative to financial aspects. Involved in strategic projects aiming to minimize case chronicity and maximize financial recovery.
Responsibilities
- Management of complex, high-stakes files: polytrauma cases, psychological diagnoses, from file opening to closure.
- In-depth analysis: identify root causes, detect inconsistencies and guide optimal decisions.
- Development and implementation of strategies: temporary reassignments, medical assessments, appeals of decisions, cost-sharing, drafting comments on the Employer's Notice, and managing reimbursement requests.
- Strategic communication: with injured employees, Operations teams, the CNESST and internal partners.
- Collaboration with internal and external lawyers to build robust cases.
- Reference and coaching role: support junior advisors, conduct workplace/site visits with the CNESST, and drive continuous improvement of OHS practices.
Requirements
- Proven experience: minimum 5 years in CNESST claims management or a similar field.
- Natural curiosity and an investigative mindset: thorough analysis and exploration of all leads.
- Strong analytical ability and instinct to identify key issues and anticipate risks.
- Strategic vision and foresight to guide decisions and optimize practices.
- Organized, rigorous and flexible, with the ability to adapt to complex situations.
- Team player with a willingness to share expertise to support the development of others.
Benefits
- Stability and balance: Permanent full-time position (40 hours per week) with a hybrid work model to support work–life balance.
- Comprehensive benefits: Group insurance including telemedicine and a group RRSP with employer contribution to help secure your future.
- Time off and personal leave: In addition to annual vacation, you receive 5 sick days and 3 personal days per year.
- Stimulating environment: Passionate colleagues, a collaborative atmosphere and strong team spirit.
- Everyday well‑being: Access to an affordable cafeteria, an on-site gym with a variety of classes (HIIT, yoga) and free parking at the Montreal office. The Québec office benefits from a convenient location near highways and many restaurants.
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