JOSEFINA

SANCHEZ

ad35s6@r.postjobfree.com

437-***-****

Brampton, ON L6R1N1

By utilizing my extensive experience adjudicating claims utilizing a multidisciplinary claim Mangement model to; ensure objective, fair and thorough claim adjudication. Effortlessly manage a large caseload of disability claims and documenting the appropriate next steps while effectively applying the adjudication process. Professionally communicate the outcome to clients over the phone as well as drafting and sending decision letters. Effectively communicating and building rapport with team members, stakeholders and business partners using a variety of techniques.

PROFESSIONAL SUMMARY

RBC Insurance - Senior Disability Claims Specialist 02/2023 - Current

Safeguard Products - Claims Supervisor

12/2017 - 02/2023

Bank of Montreal - Dispute Resolution Specialist

12/2011 - 12/2017

Staples Canada - Customer service Rep

12/2008 - 01/2011

WORK HISTORY

Evaluate, monitor and manage short term disability (STD), and long term disability (LTD) claims

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Receive, review, follow up, and communicate a determinate whether medical documentation is satisfactory to make a decision on the claim

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Manage non-compensable and compensable illness and injuries with requested appropriate medical inquiries and interventions

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Lead and monitor the development of best practices in disability management

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Manages all facets of claim evaluation for assigned claims, particularly with respect to cause and effect and relating the injury to the accident or illness

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Collaborate with medical specialists and legal counsel within the organization in order to make a decision on a claim

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• Present round table reviews for more

• Complex claims

Monitors the recovery progress of claimants with the purpose of ensuring the employee receives appropriate medical care and is working towards an early and successful return to work

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• Create weekly, monthly and yearly performance reviews. ADDITIONAL INFORMATION

Presented in many Round table Reviews with our director, senior managers, clinical specialists and legal counsel to explain complex disability cases and provide my solutions and gain direction from

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SKILLS

• COMMUNICATION

• Excel

• Microsoft Office

• Team building

• Time management

• Critical thinking

• Problem Anticipation

• And resolution

• Quality assurance

• Prioritizing and planning

• Employee Training Oversight

• Staff Recruitment and hiring

• Interviewing

• Conflict Management

• Analytical and Critical Thinking

• Good Telephone Etiquette

• Computer Skills

• Social Perceptiveness

• Attention to Detail

• Analytical Thinking

• Data Entry

• Cultural Awareness

• Research

• Remote Office Availability

• Critical Thinking

Organization and Time

Management

•

Archbishop Romero

high school Diploma

Centennial college

Business Administration (currently

obtaining)

EDUCATION

Humber College

Etobicoke, ON • 12/2015

Paralegal Education: Law And

Justice

them as well. We have resolved many complex claims in these reviews and it has developed my skills in preparing and presenting in a professional setting.

I developed a Rewards and Recognitions system for my previous employer. This provided different incentives for employees and managers for a job well done. This system reduced our call outs and lates by 90%. It was implemented two years ago and is still in place today, it rewards employees with gifts cards, PTO Time off and being able to change their schedule for a month.

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I currently oversee our social committee where we come up with fun games and events for our employees. We do everything from Christmas parties to pizza days and it really keeps everyone positive and uplifted. LEADERSHIP EXPERIENCE

Available upon request.

REFERENCES

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