Adjudicator, Claims Services

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    "ShortDescriptionStr": "At 3sHealth, we believe in supporting those who care for others.  Our Employee Benefits department lives by the philosophy: “We Take Care of the Caregivers”.  We are proud to provide compassionate, proactive and collaborative support to our plan members across the province.",
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    "ExternalDescriptionStr": "<p>Closure Date:&nbsp;June 24, 2026, 11:59 PM CST</p><p>Position #: 075838</p><p>Union: Out of Scope</p><p>Bargaining Unit:&nbsp;OOS - 3sHealth T&amp;C</p><p>City/Town:&nbsp;Regina</p><p>Facility: 3sHealth</p><p>Department: Employee Benefits</p><p>Type: Full-time permanent</p><p>Expected Start Date: July 6, 2026</p><p>Number of positions: 2</p><p>Hours of Work: 1 week rotation&nbsp;</p><p>Salary:&nbsp;Pay Band 4 ($69,051 to $89,766)</p><p><strong>About the Role</strong></p><p>3sHealth is seeking knowledgeable and motivated Claims Adjudicators to join our Employee Benefits team. In this role, you will be responsible for the adjudication and proactive case management of short-term (bridge) and long-term disability claims under the Disability Income Plans.</p><p>You will work closely with plan members, employers, healthcare providers, and internal partners to support recovery, optimize treatment outcomes, and facilitate safe and timely return-to-work solutions. This position plays a key role in balancing compassionate client service with sound decision-making and effective cost management.</p><p><strong>What You’ll Do</strong></p><p>Claims Assessment &amp; Eligibility</p><ul style=\"list-style-type: disc;\"><li>Assess disability claims to determine initial and ongoing eligibility in accordance with Disability Income Plan provisions.</li><li>Verify plan membership eligibility and ensure complete and accurate documentation is maintained.</li><li>Review, interpret, and evaluate medical information to determine total disability status.</li><li>Establish recovery expectations and develop strategies to support treatment and return to work.</li><li>Set medical review requirements and coordinate referrals to medical consultants as needed.</li></ul><p>Claims Management &amp; Coordination</p><ul style=\"list-style-type: disc;\"><li>Coordinate internal and external resources such as rehabilitation consultants, medical consultants, and independent medical examination providers.</li><li>Guide plan members through applications for other benefit sources (e.g., CPP Disability, Workers’ Compensation, third-party liability).</li></ul><p>Appeals &amp; Decision Review</p><ul style=\"list-style-type: disc;\"><li>Reassess claims and supporting medical information during appeals and peer review processes.</li></ul><p>Collaboration, Communication &amp; Stakeholder Engagement</p><ul style=\"list-style-type: disc;\"><li>Communicate clearly and professionally with plan members, employers, unions, physicians, and other stakeholders.</li><li>Attend meetings and represent 3sHealth at litigation-related examinations for discovery, as required.</li><li>Provide guidance on plan interpretation, policies, and legislation in line with federal and provincial requirements.</li></ul><p>Policy, Process &amp; Continuous Improvement</p><ul style=\"list-style-type: disc;\"><li>Contribute to the development and review of policies, procedures, forms, and educational materials.</li><li>Participate in projects, system testing, service level tracking, and continuous improvement initiatives.</li><li>Share best practices and industry knowledge gained through seminars and professional development.</li></ul><p>&nbsp;</p><p><strong>What You Bring</strong></p><p><strong>Education:</strong></p><ul style=\"list-style-type: disc;\"><li>Bachelor’s degree in Nursing, Social Sciences, Kinesiology, Rehabilitation, or a related field.</li><li>Medical Terminology Certificate is required.</li><li>A combination of directly related education and experience may be considered.</li><li>Successful candidates must complete the recommended Surge micro credential modules in adjudication and case management through SaskPolytech within their first year of employment.</li></ul><p><strong>Experience:</strong></p><ul style=\"list-style-type: disc;\"><li>Minimum of five years of experience in claims adjudication, the insurance industry, or a clinical environment.</li><li>Two years of experience in case management would be an asset.</li></ul><p><strong>Skills &amp; Competencies:</strong></p><ul style=\"list-style-type: disc;\"><li>Strong analytical and decision-making abilities.</li><li>Excellent written and verbal communication skills.</li><li>Proven time management and organizational skills in a fast-paced environment.</li><li>Customer-focused, collaborative, and solutions-oriented mindset.</li><li>Ability to manage conflict and navigate complex, high-pressure situations with professionalism.</li><li>Proficiency in Microsoft Office and related systems.</li><li>Demonstrated integrity, accountability, and alignment with 3sHealth values.</li></ul><p>&nbsp;</p><p><strong>What We Offer&nbsp;</strong></p><p>At 3sHealth, we value our culture of collaboration and continuous improvement, and we are honored to have been named one of Saskatchewan’s Top Employers for ten consecutive years. We are an organization dedicated to employee engagement and proudly celebrate our commitment to Truth and Reconciliation, and diversity and inclusion initiatives.</p><p>3sHealth has excellent opportunities for increasing levels of responsibility, personal growth and challenge. We offer a comprehensive benefits package not limited to:</p><ul style=\"list-style-type: disc;\"><li>Four (4) weeks’ vacation leave upon initial hire and 12 scheduled days off (pro-rated)</li><li>Enhanced dental and extended health plans</li><li>Group life insurance coverage</li><li>Flexible spending plan: employees can choose between the health spending account and the lifestyle spending account</li><li>A robust Employee and Family Assistance Program (EFAP) that includes counselling, legal and financial services, amongst others</li><li>Access to the Saskatchewan Health Employees’ Pension Plan (SHEPP)</li></ul><p>&nbsp;</p>",
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    "CorporateDescriptionStr": "<body>\n  3sHealth provides province-wide shared services to support Saskatchewan's health system. Working together with health system partners, 3sHealth finds innovative solutions to complex problems so that health care will be sustainable for future generations. 3sHealth places patients and their families at the centre of all that it does, working with partners to improve quality and ensure patient safety. 3sHealth provides payroll and scheduling services, employee benefits, dictation and transcription services, linen services, provincial contracting, and transformational services to the Saskatchewan health system. \n</body>",
    "ExternalPostedStartDate": "2026-06-10T22:00:00+00:00",
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    "OrganizationDescriptionStr": "<div>\n Applicants must upload all relevant documents (ex: certificates, diplomas, proof of enrollment, licenses and/or memberships) relating to the qualifications of the position.&nbsp; By submitting your application, you consent to your application history and talent profile being shared with Human Resources and the applicable hiring team.\n</div>\n<div>\n <br/>\n</div>\n<div>\n Only applicants selected for an interview will be contacted. Those being interviewed are required to bring a valid Criminal Record Check (CRC) to the interview; it must be dated within six (6) months and include a vulnerable sector search.&nbsp;\n</div>\n<div>\n <br/>\n</div>\n<blockquote style=\"margin: 0 0 0 40px;border: none;padding: 0px;\">\n <div><i>We work together to improve our health and well-being. Every day. For everyone.</i>\n </div>\n</blockquote>\n<blockquote style=\"margin: 0 0 0 40px;border: none;padding: 0px;\">\n <div>\n  We are committed to building a representative, diverse, inclusive, and culturally responsive workforce.\n </div>\n</blockquote>\n<blockquote style=\"margin: 0 0 0 40px;border: none;padding: 0px;\">\n <div>\n  We are committed to the Truth and Reconciliation Commissions Calls to Action.\n </div>\n</blockquote>\n<blockquote style=\"margin: 0 0 0 40px;border: none;padding: 0px;\">\n <div>\n  We work in the spirit of truth and reconciliation, acknowledging Saskatchewan as the traditional territory of First Nations and Métis People.\n </div>\n</blockquote>\n<div>\n <br/>\n</div>\n<div>\n Please note:&nbsp; Only applications that include all required documentation will be considered.\n</div>",
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