Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Natalie Delisle

Montreal,QC

Summary

Talented Case Manager with 15 years of experience, solid and consistent results. Adept at handling high caseloads without sacrificing quality. Operates in high-pressure environments while recommending best resources and courses of action to benefit all stakeholders. Work well with a team and individually, self-disciplined to meet and maintain targets.

Overview

22
22
years of professional experience

Work History

LTD Case Manager

Manulife Financial
01.2008 - Current
  • Develop and implement comprehensive case management plans to address client needs and goals.
  • Interpret and apply all contractual provisions as appropriate
  • Make fair and balanced claims decisions, and effectively communicate these decisions to claimants and employers
  • Ensures RTW is recommended at the right time and that any and all safety concerns are addressed.
  • Prioritize claims and quickly identify claims where outcomes can be impacted and durations shortened.
  • Liaise and partner with various internal departments such as Rehab, Mental Health Specialists, Medical Consultants, Legal Consultants, Short Term Disability case managers
  • Maintain service level agreements and turnaround times
  • Support team members as need arises
  • Claim resolutions (reserves and claim volume) above team average for 2023


Sr. Bilingual Claims Examiner, Non-medical Travel

RBC Insurance
04.2005 - 01.2008
  • Adjudication of claims, with respect to various policies
  • Approval of payments and denials for Junior Examiners
  • Help with training of staff and answers questions from Junior Examiners
  • Appeals process: Review of client' appeals, obtaining all necessary additional documentation, prepare file for review by appeals committee or Rounds Review, presenting the appeal, writing decision letter, communicating the decision
  • Handled complaints and grievances using negotiating and problem-solving skills.


Customer Service/AAI Representative

RBC Insurance
05.2002 - 04.2005
  • Take notices of claims ensuring client is aware of all claims procedures and pertinent details of their policy and coverage
  • Refer clients to providers within our Network and make arrangements with providers as necessary
  • Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.

Education

Bachelor of Arts - Travel, Tourism, Hotel & Restaurant Management

Champlain College
St. Lambert, QC
08.1994

Skills

  • Case Management
  • Quality Assurance Controls
  • Resource Identification
  • Emotional Awareness
  • Relationship Building
  • Conflict Resolution
  • Problem-Solving
  • Positive Attitude
  • Organization and Multitasking
  • Indirect Patient Care
  • Cross-Functional Collaboration
  • Documentation and Reporting

Languages

English
Native or Bilingual
French
Professional Working

Timeline

LTD Case Manager

Manulife Financial
01.2008 - Current

Sr. Bilingual Claims Examiner, Non-medical Travel

RBC Insurance
04.2005 - 01.2008

Customer Service/AAI Representative

RBC Insurance
05.2002 - 04.2005

Bachelor of Arts - Travel, Tourism, Hotel & Restaurant Management

Champlain College

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Natalie Delisle