As a Clinical Specialist, you will analyze medical information related to disability claims in a collaborative, multi-disciplinary digital environment. You will work also proactively partner with claim adjudicators, doctors and rehabilitation specialists to provide input, set clinical direction and implement clinical strategies across multiple product lines for Life & Health Claims to deliver effective service solutions to enhance outcomes. You will participate in projects and initiatives.

What is the opportunity?

As a Clinical Specialist, you will analyze medical information related to disability claims in a collaborative, multi-disciplinary digital environment. You will work closely with claim adjudicators, physicians and rehabilitation specialists to provide expert input, set clinical direction and implement clinical strategies across various Life & Health product lines to deliver effective service solutions to enhance outcomes. You’ll have the opportunity to contribute to key projects and initiatives.

What will you do?

• Responsible for critical analysis of medical information on Life & Health claims to assess the nature, extent and impact of medical or psychiatric conditions, as well as medical restrictions and limitations and expected recovery timelines.

• Responsible for completing thorough and objective clinical reviews, for accurately documenting the information and for delivering quality, cost efficient work product within established service standards.

• Provide input, set clinical direction and implement clinical strategies across multiple product lines for Life & Health Claims.

• Take ownership of client problems through first call resolution coaching and escalate as appropriate.

• Proactively collaborate with claim Adjudicators, Physicians, and Rehabilitation Specialists to deliver effective service solutions.

What will you need to succeed?

Must have:

• RN or BSCN designation in nursing required

• Strong analytical and decision-making skills as well as excellent oral and written communication skills.

• 5 years’ experience of current, proven clinical experience, in occupational health, rehabilitation or case management, industrial disability management, worker’s compensation, psychiatric, cardiac, emergency care or orthopedic nursing.

• Demonstrated ability to effectively deal with customers in a manner that is professional with a high degree of customer service.

• Demonstrated ability to thrive in a high-pressure environment with times constraints.

• Proficiency in MS Office application, PowerPoint, and\or similar applications.

Nice to have:

• Demonstrate a growth mindset and ability to adapt to challenges, learning from experiences and continuously improving performance.

• Bilingualism in French and English, both written and spoken.

What's in it for you?

• A Total Rewards program that includes flexible benefits, work/life balance and career development programs and investment and retirement savings plans

• Competitive pay and high-earning potential

• All the tools, training, and team support you need to grow your career

• Flexible work/life balance options

• RBCI software tools to boost your productivity

RBC is an organization that succeeds by bringing out the best in its people. You’ll be part of a supportive, inclusive team that shares common values – including a fundamental respect for each other. At the heart of this is a commitment to diversity. RBC respects and responds to the many competing and evolving priorities in our lives – so you can focus on what you can do best – putting clients first.

Job Skills

Coverage Analysis, Critical Thinking, Customer Service, Insurance Claims Investigations, Insurance Operations, Insurance Product Development, Knowledge of Claims, Long Term Planning, Settlement Negotiations

Additional Job Details

MEADOWVALE BUSINESS PARK, 6880 FINANCIAL DR:MISSISSAUGAMISSISSAUGACanada37.5Full timeINSURANCERegularSalaried2025-05-262025-06-10

Note: Applications will be accepted until 11:59 PM on the day prior to the application deadline date above

Inclusion and Equal Opportunity Employment

At RBC, we believe an inclusive workplace that has diverse perspectives is core to our continued growth as one of the largest and most successful banks in the world. Maintaining a workplace where our employees feel supported to perform at their best, effectively collaborate, drive innovation, and grow professionally helps to bring our Purpose to life and create value for our clients and communities. RBC strives to deliver this through policies and programs intended to foster a workplace based on respect, belonging and opportunity for all.