Administrative Support - Health Services

Salary and Hours of Work

• Hours of work are those required to perform the assigned tasks but shall not be less than 35 hours per week, 7 hours per day. Monday to Friday between 8:00-5:00 PM.
• The hourly rate for this position is $28.53 to $32.49. CUPE 1866 employees receive Step 1 of the pay band for the position appointment.

Responsibilities

• Handle incoming and outgoing calls to assist clients, service providers, pharmacies, co-workers, and case managers with administrative and medical-related requests. Gather client information for medications and medical reports to ensure accurate and up-to-date file management.
• Prepare and send drug rejection letters on behalf of the claim owner, ensuring all relevant policies, legislation, and supporting rationale provided by a Nurse Consultant are included. Act as the primary liaison between clients, pharmacies, service providers, and Nurse Consultants, ensuring clear and timely communication regarding prescription requests, drug authorizations, rejections, and medical information updates.
• Oversee and track the Independent Medical Examination (IME) referral process, including handling service provider invitations, tracking awards, and ensuring accurate document uploads. Maintain detailed records in a complex Excel spreadsheet while serving as the liaison between case managers, clients, and service providers.
• Engage with a roster of potential service providers and allocate referrals in accordance with procurement processes and the master service agreement. Administer and monitor the two-stage competitive process for fairly awarding IME referrals, ensuring compliance with procurement guidelines and selection criteria.
• Assist clients with completing LTD questionnaires and respond to their inquiries. Send Age 65 letters three months before benefits cease, reviewing prescription lists to determine if funding requests should be forwarded to Nurse Consultants. Conduct SF-36 and QPD questionnaires verbally with clients and submit them for review to assess medication funding eligibility.
• Responsible for sending medical information requests to Service Providers (e.g., Physicians, Hospitals, Chiropractors, Physiotherapists) and following up to ensure timely receipt of the required documentation.
• Arrange travel logistics for clients attending medical appointments, including hotel reservations, taxi services, flights, and ferry arrangements. Communicate with clients and service providers to finalize plans and submit travel advance requests to the Benefits Payments Department. Ensure case managers and clients receive timely updates on travel arrangements.
• Other duties may be assigned as needed or based on operational requirements

Qualifications

• A one (1) year post-secondary diploma or certificate in medical health services, office administration, business, health services or a related field.
• Minimum of one (1) year of experience in a clerical, administrative, or customer service role, preferably within healthcare, insurance, or a workers' compensation environment. Proven experience delivering client-focused support, including clear communication, problem-solving, and coordination with pharmacies, healthcare providers, or insurance representatives for prescription requests and special authorizations. Familiarity with claims processing, case management support, workforce re-entry, and pensions or long-term disability (LTD) programs, including knowledge of relevant policies, procedures, and applicable legislation.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook, Teams), SharePoint, Adobe Acrobat Pro, Case Management systems, and the Automated Benefits Claims Center (ABCC) to support documentation, communication, and workflow coordination.
• Knowledgeable in Claims Management processes, including Workforce Re-entry, Pensions, and Long-Term Disability, with a strong understanding of related systems, policies, and applicable legislation.
• Familiar with medication approvals, special authorizations, and collaboration with pharmacies and healthcare providers.
• Understanding of Independent Medical Examination (IME) referral processes, compliance standards, and accurate record-keeping protocols.
• An equivalent combination of greater education, combined with less work experience may be considered.

Competencies

Written and spoken competence in English and French is required.