Ismail MAIGA
Toronto,ON
Summary
Bilingual Disability Case Manager | 3+ years experience | STD and LTD
I have a background in psychology (B.A.) and human resources (M.A.), complemented by a certificate in mental health and disability management. I have a good understanding of disability management, medical terminology and the concept of accommodation and return to work. With over 3 years experience in disability management, I am committed to providing excellent customer service and have the ability to make sound decisions, supported by strong rationale. As a calm and patient person, I am a dedicated listener and demonstrate a high level of empathy, which fosters a compassionate and supportive approach. My disability management experience includes:
- conducting comprehensive assessments and developing comprehensive case management plans.
- Facilitating effective communication between stakeholders.
- Managing cases from initial intake to resolution.
- Collaborating with interdisciplinary teams such as to achieve a rapid and safe return to work.
Overview
10
10
years of professional experience
Work History
Bilingual Disability Case Manager
Beneva
11.2021 - Current
- Proactively manage a dedicated caseload in compliance with specific service level agreements and targeted turnaround times.
- Conduct medical investigation by phone or in writing to the applicant, employer, physicians and treating physicians.
- Ensured accurate and thorough documentation of all interactions with insureds, employers, and treating physicians via phone calls, emails, and letters.
- Assessing claims based on contractual, medical, and vocational barriers.
- Collaborated with plan sponsors, plan members, treatment providers, and internal partners such as disability specialists, rehabilitation specialist, and medical consultants to build strong relationships and achieve successful return to work or job ready resolution.
- Writing letters to communicate pertinent benefit related information based on analytical reasoning.
- Investigate pre-existing conditions, if applicable, for long-term disability claims to determine insureds' eligibility.
- Actioning daily administrative tasks which include responding to emails and telephone calls on a timely manner.
- Provided exceptional customer service and support for assigned files, handling calls from all involved parties.
Bilingual Intake Case Manager
Canadalife
05.2017 - 11.2021
- Review system, claim documents and contract to confirm if eligibility requirements are met.
- Accountable for the outreach call to Plan Sponsors and Plan Members within 24 hours of receipt of initial claim information.
- Responsible to communicate via phone calls/emails to verify any discrepancies, missing or unclear information from either Plan Sponsor or Plan Member.
- Responsible for declination letter to Plan Sponsor and Plan Member accordingly.
- Adjudicate and manage the claim if expected to be for a limited duration (known as Quick Pay claims).
- If claim does not meet eligibility for a Quick Pay claim, transfer the claim to the Disability Case Manager for claim adjudication and management and to DCAs for benefit calculation.
- File documents accordingly.
Bilingual Customer Service Representative
Medavie
03.2014 - 05.2017
- Respond to a high volume of customer calls as a first point of contact.
- Understand member’s needs.
- Provide effective first-call resolution strategies.
- Provide information on health care benefits and plan eligibility.
- Quote and sell travel insurance to new and existing customers.
- Assist existing customers by providing sound and helpful advice in response to their travel insurance questions, payment inquiries and other general questions.
- Provide information on health care benefits and plan eligibility.
- Follow up on customer needs. Perform profile updates.
- Process insurance transactions in accordance with underwriting and compliance guidelines to meet quality expectations.
- Use established procedures in a fast-paced, computerized environment.
- Obtain and/or maintain provincial licenses.
- Work closely with different departments, partners and collaborators.
Education
Certificate - Mental Health And Disability Management
Université De Sherbrooke
Longueuil, QC06-2017
Master of Science - Human Resource Management
Université De Laval
Laval, QC12-2015
Bachelor of Arts - Psychology
Concordia University
Montreal, QC05-2012
Skills
- Excellent customer service and telephone skills, comfortable with both inbound and outbound calls
- Excellent communication skills focused on building and maintaining strong customer relationships
- Strong organizational and prioritization skills
- Ability to work with minimal supervision
- Understanding of medical terminology, accommodation and return to work concept
- Ability to make sound decisions, supported by strong rationale
- Effective interpersonal skills including negotiation and facilitation where conflicting needs exist
- Outstanding listening skills with demonstration of empathy
- React quickly and effectively to changing priorities
- Ability to quickly collect information
- Adaptability and flexibility
- Emotional intelligence
- Attention to detail
- Ability to multi-task
- Analytical skills
- Excellent Problem-solving and decision making skills
- Professional written and oral communication skills
- Dynamism and team spirit
- Ease of learning and integration
- Computer skills: MS Office, Adobe, Chronos, Citrix, Fineos
Languages
French
Native/ Bilingual
English
Native/ Bilingual
Arabic
Native/ Bilingual
Spanish
Professional
Interest / Activities
- Writing: blog creation, Verillusion sharing
- History, reading, cinema, painting
- Volunteer in an association for disadvantaged children (Coordinator of Biig-Néré, Ouagadougou, Burkina Faso)
- Sports: Basketball, Handball and Fitness
References
References available upon request.
Timeline
Bilingual Disability Case Manager
Beneva
11.2021 - Current
Bilingual Intake Case Manager
Canadalife
05.2017 - 11.2021
Bilingual Customer Service Representative
Medavie
03.2014 - 05.2017
Certificate - Mental Health And Disability Management
Université De Sherbrooke
Master of Science - Human Resource Management
Université De Laval
Bachelor of Arts - Psychology
Concordia University
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