Catastrophic Claims Advisor

Relevance; Burlington; Hybrid; CAD 75,000 - 110,000; Full time

Benefits offered by this job

Competitive salary and annual bonus

Defined benefit pension plan

Group insurance including telemedicine

Telework equipment reimbursement

Job summary

Desjardins in Ontario seeks a Catastrophic Claims Advisor to guide clients through complex accident benefits claims. You will collaborate with healthcare providers, legal representatives, rehabilitation specialists, and other stakeholders to support functional recovery with empathy and professionalism.

Responsibilities include investigating high-complexity claims, communicating updates, coordinating settlements, and ensuring timely claim payments in line with regulatory and company standards.

Qualifications

• Bachelor's degree in a related field.
• Five years of relevant experience in accident benefits claim handling.
• CIP designation or enrollment in CIP program is preferred.
• Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule).
• Experience coordinating with medical, legal, and rehabilitation professionals.

Responsibilities

• Investigate, evaluate and negotiate high complexity accident benefit claims.
• Maintain clear, timely communication with clients and update them on claim status.
• Manage Catastrophic claims with focus on functional recovery.
• Identify and resolve challenges to achieve fair outcomes and client well-being.
• Conduct settlement discussions and negotiate resolutions.
• Collaborate with internal and external legal counsel on LAT disputes and mediations.
• Coordinate with medical, legal and rehabilitation professionals to support recovery and resolution.
• Apply accurate reserving practices and ensure timely claim payments.

Skills

English proficiency

Regulatory knowledge

Medical terminology

Legal terminology

Disability management principles

Vocational rehabilitation concepts

Education

Bachelor's degree in a related field

CIP designation or enrolled in the CIP program

Job description

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professional, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. The Catastrophic Claims Advisor serves as a trusted guide and advocate for clients navigating complex catastrophic claims. Partnering with healthcare providers, legal representatives, rehabilitation specialists, and other key stakeholders, the advisor provides guidance, advocacy, and coordination throughout the claims process. Combining technical expertise with professionalism, empathy, and compassion, the role focuses on supporting each client's functional recovery, and ensuring their unique needs are met through a personalized, client-centered approach. You will be a key contributor to our mission of delivering exceptional claims service and client care. More specifically, you will be required to:

• Investigate, evaluate and negotiate accident benefit claims of high complexity, ensuring compliance with regulatory and contractual obligations, as well as DGIG best practices
• Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims process
• Manage Catastrophic claims with a keen focus on functional recovery
• Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well-being
• Conduct settlement discussions and negotiate resolutions where appropriate
• Collaborate with internal and external legal counsel on LAT disputes, reconsiderations, judicial reviews, mediations, and hearings
• Collaborate effectively with internal and external stakeholders - such as medical professionals, legal representatives, and rehabilitation providers - to support client recovery and claim resolution
• Apply accurate reserving practices and ensure timely issuance of claim payments in accordance with company standards and best practices.

What we offer*

• Competitive salary and annual bonus
• Salary range : $75 009 to $110 014 per year (Toronto suburbs)
• 4 weeks of flexible vacation starting in the first year
• Defined benefit pension plan that provides predictable, stable income throughout retirement
• Group insurance including telemedicine
• Reimbursement of health and wellness expenses and telework equipment

*Benefits apply based on eligibility criteria.

#LI-Hybrid, #ON09*

What you bring to the table

• Bachelor's degree in a related field
• A minimum of five years of relevant experience in accident benefits claim handling
• Please note that other combinations of qualifications and relevant experience may be considered
• Advanced experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery
• CIP designation or enrolled in the program
• Advanced proficiency of English due to the nature of the duties or work tools or because the position involves interactions with English-speaking partners, members and/or clients
• Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule)
• Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts and disability management principles

Action oriented, Business insight, Complexity, Customer Focus, Decision quality, Differences, Interpersonal Savvy, Nimble learning

Equity, Diversity, Inclusion and Accessibility

At Desjardins, we believe in equity, diversity and inclusion.

We're committed to welcoming, respecting and valuing people for who they are as individuals, learning from their differences, embracing their uniqueness, and providing a positive workplace for all.

At Desjardins, we have zero tolerance for discrimination of any kind.

We believe our teams should reflect the diversity of the members, clients and communities we serve.

If there's something we can do to help make the recruitment process or the job you're applying for more accessible, let us know.

We can provide accommodations at any stage in the recruitment process.

Just ask!

Job Family

Member/client sales and service (FG)

Desjardins uses tools that incorporate artificial intelligence functionalities to screen or assess applicants as part of the recruitment process for this position.