Claims Adjudicators

Title: Claims Adjudicators

Location: New Brunswick

Job Description:

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The Opportunity

 

WorkSafeNB is creating an inventory of casual full-time Claims Adjudicators to support future hiring opportunities. These positions require a linguistic profile of Bilingual written and spoken.

Reporting to the Manager, Adjudication Services, you will provide superior client service by rendering quality decisions in a timely fashion on claim entitlement and providing timely access to care for workers. This includes medical aid and loss of earnings entitlement. You will support the worker in their recovery and enable the worker to stay at work and/or return to work. To protect the integrity of the system, you will make decisions in compliance with Workers Compensation Act or any other relevant legislations, and WorkSafeNB policies, directives, and standard operating procedures.
 

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 per day. Monday to Friday between 8:00-5:00 PM.
The pay scale for this position is $40.84 per hour. CUPE 1866 employees start at Step 1 of the pay band for the position appointment. 

Responsibilities

 

Providing quality and timely decisions on claim entitlement in keeping with established service standards by claim type for all new claims, reconsiderations and recurrences while maintaining compliance with legislation, policies and procedures.
Communicating the adjudication decisions clearly and concisely by preparing decision letters, in a timely fashion, for the workers, employers, service providers, etc. anchored into legislation and policies.
Gathering and requesting any information and evidence required to complete and weigh it, using administrative justice principles, to ensure quality and timely adjudication decisions are made in accordance with legislation, policies, and standard operating procedures.
Evaluating and determining if new incoming information is material and substantial and a claim decision should be reconsidered or if a new decision is required.
Utilizing disability duration guidelines to educate and create expectations regarding stay at work and return to work options with workers, employers, and service providers. Initialize stay at work or return to work processes.
Initiating, supporting, authorizing, and setting up the medical rehabilitation plan (including return to work plans) in accordance with legislation, policies, and standard operating procedures.
Evaluating and taking appropriate action on incoming information.
Identifying issues impacting the claim, recovery, and stay/return to work and coordinate appropriate referrals when indicated.

Qualifications

 

Candidates are required to demonstrate on their application all of the qualifications, knowledge, skills and/or abilities in the following areas, in order to be given further consideration:

A completed University Degree in business, law, education, health care, social sciences, kinesiology, or a related field. 
Must have a minimum two years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience such as, but not limited to: 

1. Making adjudicative decisions or entitlement decisions or insurance claims decisions based on a defined set of criteria (i.e., policies, procedures, legislation, etc.).
2. Applying law and/or policy to make determinations based on a defined set of criteria (i.e., policies, procedures, legislation, etc.).
3. Caseload management.
4. Managing and assessing workplace-based programs.
5. Writing high-level decision documents for presentations at quasi-judicial hearings.
6. Working in a health care field with experience in having gained knowledge of medical terminology/issues and an ability to interpret medical reports.

Ability to provide superior client service in, sometimes, confrontational, and sensitive situations. 
Ability to communicate effectively complex and difficult concepts in a clear and concise manner, both verbally and in writing.
Ability to plan and organize in a fast-paced and high-demanding environment with multiple competing priorities. Ability to work under pressure to meet tight deadlines while providing excellent client service. 
Ability to objectively review information and apply independent reasoning for quality and timely decision-making in a fast-paced, high-volume work environment. Ability to obtain, assess and evaluate information to support claims decisions. This requires a high level of attention to details. 
Ability to interpret and apply provisions, policies, procedures, and legislation. Understanding of the Workers Compensation Act, Firefighters Act and any other relevant legislation and policies. 
Ability to work and communicate well with others during day-to-day activities and to collaborate with others to achieve team goals.

The following equivalent combination of education, training and experience may be considered:

A completed two (2) year post-secondary education diploma in business, law, health care or social science-related fields, or a related field with four (4) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.
Or a completed one (1) year paralegal post-secondary education diploma with five (5) years of experience in a decision-making capacity interpreting and applying policies, procedures, and/or legislation within a client service environment, or related experience as defined above.

Competencies:

Client-focused Service
Teamwork and Collaboration
Adaptability
Ensuring Accountability
Decision Making
Analytical Thinking
Written Communication
Information Gathering and Processing
Resilience
Legislation and Compliance

Written and spoken competency in English and French are required for these positions.

Your primary workspace will be from your in-home office, with the occasional expectation of in person meetings, for that reason, working from outside the province of New Brunswick, or country, is not permissible.

If you are interested in pursuing this opportunity with WorkSafeNB, please apply online at www.worksafenb.ca by May 31, 2026.

We thank all those who apply however only those selected for further consideration will be contacted.

For more information about WorkSafeNB, or this and other employment opportunities, please visit our website at worksafenb.ca.

 

About Us

 

The team at WorkSafeNB is passionate about promoting health and safety in New Brunswick workplaces. We strive to make New Brunswick the safest place to work. However, injuries do occur, and when they do, we are committed to providing caring recovery and return to work services, benefits, and compensation to injured workers and their families. Culture is the heartbeat of the organization. The stronger it is, the further we go! Selected by our employees, our WorkSafeNB values shape our culture. We put our values of Accountability, Collaboration and Trust into ACTion. We demonstrate accountability by taking pride in and ownership of our work so we can take care of our clients and other New Brunswickers. Through collaboration, we build strong partnerships and innovate to achieve better outcomes. Trust guides our organization; we lead and listen with empathy and embrace diversity, inclusion and belonging. These ACTions shape us.

 

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A little bit about us

 

WorkSafeNB

 

Organization

WorkSafeNB administers no-fault workplace accident and disability insurance for employers and their workers, funded solely through assessments on employers. All employers having three or more workers are obligated to obtain compensation coverage.

WorkSafeNB is committed to preventing workplace injuries and illness through education and enforcement of the Occupational Health and Safety Act.

WorkSafeNB is administered by a board of directors consisting of the chairperson, a vice-chairperson, the president and CEO (non-voting member), the chairperson of the Appeals Tribunal (non-voting member), five members representing workers, and five members representing employers. Other than the president & CEO and the chairperson of the Appeals Tribunal, members of the board of directors serve part-time.

WorkSafeNB's mandate is to:

• Promote the creation of a workplace safety culture in which all employees and employers view all occupational diseases and accidents as being preventable.
• Promote an understanding, acceptance, and compliance with all legislation for which WorkSafeNB is responsible, including the enforcement of the OHS Act and regulations.
• Provide timely compensation benefits, medical aid, rehabilitation, and safe return-to-work services to injured workers.
• Provide sustainable insurance and insurance-related services to the employer community.
• Represent stakeholders and provide recommendations and advice to government with respect to legislation, and publish such reports, studies, and recommendations WorkSafeNB considers advisable.

Assessments are affected by the level of activities in the province's workplaces, as are the resulting claims. There are also substantial assets that ensure WorkSafeNB will be able to provide the ongoing benefits promised to injured workers through a wage loss recovery insurance system. These funds are invested in the financial markets and investment returns are subject to the ups and downs of the marketplace.

Regional Services

WorkSafeNB's head office is located in Saint John.

More Info

For more information, please visit www.worksafenb.ca

Toll Free: 1-800-999-9775