- Responsible for providing prompt, quality adjudication decisions with respect to the determination of initial claim entitlement, amount and duration of benefits payable and entitlement to appropriate services and supports for specialized claims involving psychological conditions and/or psychological trauma and/or significant/catastrophic injuries. -Responsible for being the primary point of contact for all claims related issues and respond effectively to injured workers’ needs by achieving an understanding and appreciation of their perspectives, concerns and circumstances through ongoing dialogue.- Responsible for communicating all decisions in a timely manner to interested parties verbally and in writing, explaining rationale for the decision and application of policies and sections of the relevant WSIA/WCA.-Responsible for attempting to prevent and/or resolve disputes once objections have been raised by workplace parties- Responsible for analyzing additional information, providing advice to involved parties, identifying and addressing all new issues that surface;-Responsible for dialoging and negotiating with involved parties to generate options leading to collaborative solutions, participation and commitment-Responsible for providing education on WSIB benefits, policies and processes while informing parties of their rights and obligations under the applicable WSIA/WCA.

-Responsible for the developing, implementing, and monitoring comprehensive and integrated case management plans for all activity in the case required to achieve recovery, community integration, and where possible, return to work-Providing targeted activities focused on identifying RTW factors, removing obstacles, and leveraging opportunities to facilitate a safe return to suitable work-Identify and co-ordinate intervention by internal and external specialty resources and ensure timely and appropriate completion of these interventions and services-Make entitlement decisions based upon legislation, policy, and best practices and communicate these decisions verbally and in writing to applicable parties-Responsible for attempting to prevent or resolve disputes - handle requests for reconsideration and, if appealed, arrange access and process the objection

-Responsible for making initial entitlement decisions quickly and accurately, and communicating them verbally and in writing to the workplace parties-Support workplace parties in their return to work (RTW) efforts by sharing any available information about the functional limitations and abilities of the worker-Proactively collect information from workplace parties and healthcare providers for decision-making and respond to inquiries-Inform workplace parties of their rights, responsibilities and obligations under the WSIA and applicable legislation and the consequences of non-compliance-Attempt to resolve and prevent disputes actively and handle reconsideration requests and arrange for further deliberation by the Appeals Services Branch

-Delivered initial and ongoing health care entitlement decisions based on defined criteria and policies reflecting the Workplace Safety and Insurance Act-Communicated health care entitlement decisions including adverse, or restrictive decisions verbally and in writing, to appropriate parties-Processed health care and work transition related expenses (i.e, physiotherapy, chiropractic treatment, medical devices, orthotics and supports) for payment to workers and providers as per legislation and policies-Informed and educated clients and customers of health care policies, procedures and fees and clarified status of payment, cheque amounts on Explanation of Benefits (EOB) Statements, Accident Cost statements-Referred requests to and liaised with internal WSIB parties for payment requests with respect to entitlement or clinical issues as appropriate

-Actively provided information regarding claims and policies to workers, employers, representatives and internal business partners -Responsible for keeping systems updated with current information and to deliver accurate information regarding claims-Acted as claims support and initiated claims registration for clients of the WSIB-Trained to deal with escalations, crisis calls, specialty calls and privacy breaches in a proactive manner-Provided assistance with clerical duties such as completing and submitting orders for forms and posters, requests for language services and privacy breach reports-Responsible for providing adjudicators with information and administrative support for evidence based decision making according to the Workplace Safety and Insurance Act-Provided inter departmental support as needed for the Travel Office department

-Led a team of 15 floor agents and acted as a liaison between them and the management-Provided administrative support to the management and agents on the floor as needed-Strategically and professionally handled any escalated situations with customers-Collaborated with other Team Leaders and the Quality Assurance team to determine which agents required help, coaching, motivation and support to provide excellent customer service-Managed the flow of day-to-day operations, including agent evaluation; provided the management with daily performance reports; presented at department meetings-Promoted activities that maintained and improved a high level of employee satisfaction (e.g. team building activities, debrief meetings, employee training, etc.)

-Assisted customers with general queries, complaints and product questions through inbound calls-Communicated with customers and answered all their product-related and service-related queries in a professional, courteous and pleasant manner through active/reflective listening and having a thorough knowledge of company policies-Delivered excellent customer service by providing a meaningful and positive experience to every customer -Opened and maintained customer records; updated customer records with each customer interaction-Used a proactive model to engage, assess, address and resolve customer complaints