Job Posting

APPEALS FACILITATOR

Full-time permanent – Competition #24-19
 

Position Summary

We are seeking an experienced Appeals Facilitator to join the Governance team. The Appeals Facilitator will play an integral role in coordinating the approved appeals structure, with a primary focus on policy appeals and a secondary focus on total disability appeals. Policy appeals include coverage appeals for income replacement and general health benefits as well as all claims appeals excluding total disability. Although direct engagement with covered members is limited, the ideal candidate will possess exceptional interpersonal and communication skills. They will provide administrative support to the appeal bodies. Exceptional organizational skills and attention to detail are required to ensure that appeal files are accurately prepared, appeals are heard in a timely manner, and appeal body decisions are actioned appropriately. The ideal candidate has three to five years of experience interpreting and applying policy, with demonstrated experience working with confidential materials.

Your Key Responsibilities

• Use established protocols to screen appeal requests for the following:
  • Validate individual requesting the appeal is eligible to do so.
  • Determine the operational decision can be appealed.
  • Ensure the appropriate policy/process has been applied and required internal reviews have been conducted.
  • Classify the appeal based on approved criteria.
• Assess appeal submissions, requesting additional information as required.
• Prepare confidential appeal files.
• Schedule appeal body meetings for each appeal body.
• Act as an administrative and technical resource to the appeal bodies e.g., respond to questions of fact, assist in drafting the appeal body’s decisions, and communicate the decision in writing to the appellant.
• Action appeal decision, ensuring appropriate parties are advised of decisions and informing them to proceed with payments as required.
• Liaise with operations throughout the appeals process as required.
• Maintain accurate and up-to-date records and documentation.
• Identify opportunities for continuous improvement.
• Prepare reporting as requested.
• Other duties as assigned.

Unique Working Conditions

This position is eligible to participate in the hybrid workforce program.
If you have the required qualifications and would like to become a member of our team, please submit your resume and cover letter by following the link below. This posting will remain open until the role has been filled.

https://asebp.applicantpro.com/jobs/3316692

No phone calls please. We thank all interested individuals, but only those candidates being considered for an interview will be contacted. ASEBP is an equal opportunity employer.
All offers of employment for this position are conditional upon satisfactory background and reference checks, which may include a criminal record check and/or education and employment verification.
Please note that an account will automatically be created for you during the application process if you do not have an ApplicantPro account set up already.

About the Alberta School Employee Benefit Plan

The Alberta School Employee Benefit Plan (ASEBP) is a health and welfare trust governed by ten Trustees, five of whom are appointed by the Alberta School Boards Association and five of whom are appointed by the Alberta Teachers' Association. ASEBP promotes programs that sustain healthy lifestyles and workplaces for over 60,000 covered members in almost 60 school jurisdictions across Alberta.

Working for ASEBP is about more than supplying great benefits. ASEBP offers:

• a team-focused culture that supports people and performance
• competitive compensation that goes far beyond a paycheque
• an exciting chance to make an impact in the lives of Alberta’s school employees
• advancement opportunities in a stable, growing organization
• a wide range of health and wellness initiatives that encompass mental, physical and nutritional health

For more information about ASEBP, please visit the “About” section of our website (www.asebp.ca).