Claims Adjuster - Accident Benefits

Wawanesa Insurance; Calgary; Hybrid; CAD 57,000 - 84,000; Full time

Job summary

A leading insurance provider is seeking a Claims Adjuster to manage accident benefit claims in a hybrid work environment. You will be responsible for maintaining member satisfaction through timely communication and fair claims adjustment. Candidates should possess strong customer service and analytical skills, with a preference for post-secondary education. The role also requires the willingness to achieve Chartered Insurance Professional designation. This position offers competitive salary with growth opportunities.

Benefits

Annual bonus plan

Generous vacation time

Premium free benefits

Pension plan

Qualifications

• Exceptional customer service skills demonstrating empathy and concern for member satisfaction.
• Post-secondary degree is preferred.
• Willingness to work toward Chartered Insurance Professional (CIP) designation.
• Comprehensive knowledge of medical and legal terminology.
• Excellent communication skills; listening, written, and spoken.
• Excellent investigative and analytical skills.
• Excellent time management and organisational skills.
• Excellent negotiation, decision making and critical thinking skills.
• Strong teamwork skills with the ability to collaborate with others.

Responsibilities

• Provide direction and support to our injured members through the claims process.
• Timely and proactive communication with all parties involved.
• Adjust Benefit claims of low to moderate complexity.
• Review and interpret policy wordings and determine coverage.
• Establish timely and accurate loss and expense reserves throughout the life of the claim.

Skills

Exceptional customer service skills

Excellent communication skills

Excellent investigative and analytical skills

Excellent time management and organisational skills

Strong teamwork skills

Education

Post-secondary degree

Job description

Job ID: 9702

Employment Type: Existing Role

Working Business Language: English

Salary: At Wawanesa, salary is only one component of a holistic, comprehensive and competitive offering that we provide to our employees. In addition to salary, full-time and part-time permanent employees are eligible for an annual bonus plan, leave of absence top‑up programmes and provided with generous vacation time, personal days, premium free benefits and pension plan. The salary offered for this role is determined with consideration to various factors, including but not limited to: your work location, local labour market conditions, external market salary data, internal pay equity and the knowledge, skills, experience and anticipated proficiency in the role. If you are interested in a level 1 or 2 opportunity, please apply. We will determine level based on technical assessment during the interview. The salary offered is estimated to be within the following range for Level : $57,000‑$74,000. The salary offered is estimated to be within the following range for Level 2: $63,000‑$84,000. Candidates with salary expectations outside of the range are still encouraged to apply.

About Us

At Wawanesa, we offer a hybrid work environment that offers flexibility to our employees in balancing in‑office (2 days per week OR 15 hours per week in a Wawanesa office) and remote work. You may work from any of the following locations: Calgary, AB; Edmonton, AB; Lethbridge, AB. The Wawanesa Mutual Insurance Company (“Wawanesa Mutual”), founded in 1896, is one of Canada’s largest mutual insurers, with over $3.5 billion in annual revenue and assets of $10 billion (CAD). Wawanesa Mutual, with its National Headquarters in Winnipeg, is the parent company of Wawanesa Life, which provides life insurance products and services throughout Canada, and Western Financial Group, which distributes personal and business insurance across Canada. Wawanesa proudly serves more than 1.7 million members in Canada, and we are home to more than 3 300 employees distributed across the Canadian regions and communities where we operate. We give back to organisations that strengthen communities, donating more than $3.5 million annually to charitable organisations, including over $2 million annually in support of people on the front lines of climate change. We are also proud to be recognised as one of Manitoba’s Employers. To learn more visit wawanesa.com.

We are currently looking for dedicated, driven, and enthusiastic individuals who thrive in an environment that welcomes change and are looking for an opportunity for diverse experience and advancement on a growing team.

Job Overview

The Claims Adjuster, Accident Benefits contributes to Wawanesa’s goal of delivering an exceptional and consistent member (policy holder) experience through the fair and equitable adjustment of low to high complexity accident benefit claims depending on the level. This role is responsible for applying and explaining policy coverages and documenting claim files through the life of a claim. The role is accountable for providing timely service and prompt management of your claims pending from initial report to conclusion.

Job Responsibilities

• Provide direction and support to our injured members through the claims process, by providing an exceptional member experience delivered with empathy.
• Timely and proactive communication, through voice to voice, digital and written correspondence, ensuring that all inquiries are effectively dealt with in a timely and professional manner.
• Level 1: Adjustment of Benefit claims of low to moderate complexity.
• Level 2: Adjustment of Accident Benefit claims of moderate to high complexity.
• Review and interpret policy wordings, determine policy coverage, and communicate coverage decisions to members.
• Establish timely and accurate loss and expense reserves throughout the life of the claim through evaluation of relevant information from various sources such as medical, legal, financial, and vocational.
• Ensure a comprehensive investigation is conducted on all files to determine coverages and liability, while adhering to Wawanesa’s adjusting guidelines, and recognising when to engage appropriate internal and external resources.
• Coordinate and manage services with vendors and service providers such as accountants, lawyers, rehabilitation clinics and health practitioners.
• Negotiating and conveying claim settlements within authority limits. Communicating claim decisions promptly and effectively, while still delivering an exceptional member experience. Manage claims in litigation, mediation, or arbitration. Provide instruction to assigned counsel.
• Maintain an effective and current diary system and document claim file activities in accordance with established procedures and Wawanesa's Proactive Case Management Model.
• Demonstrate and maintain knowledge and understanding of policy coverages, while complying with regional regulatory and licensing requirements (as applicable). Remaining current with legislative changes and trends in the insurance industry.
• Liaise with claimants, doctors and rehabilitation specialists Doctors, Lawyers, Employers, Treatment Providers, Case managers, Clinical Resource Team, Return to Work Team, and Injured Members in accordance with Wawanesa's Proactive Case Management approach. Occasionally participate at private mediation, court proceedings and other dispute resolution as required.
• Within a limited role contribute to employee development through training, technical guidance, and coaching.
• Perform other duties as assigned.

Qualifications

All Levels

• Exceptional customer service skills demonstrating empathy and concern for member satisfaction.
• Post‑secondary degree is preferred.
• Willingness to work toward Chartered Insurance Professional (CIP) designation and where required, dedicated to reach the proper licensing requirements.
• Comprehensive knowledge of medical and legal terminology.
• Excellent communication skills; listening, written, and spoken.
• Excellent investigative and analytical skills. Detail oriented with a high degree of accuracy regarding data entry.
• Excellent time management and organisational skills with the ability to prioritise work in a fast paced, changing environment.
• Excellent negotiation, decision making and critical thinking skills.
• Strong teamwork skills with the ability to collaborate with others.

Level 1

• 1 year of insurance adjusting experience or equivalent.

Level 2

• 2 years of insurance adjusting experience or equivalent.

Diversity Equity, Inclusion & Belonging

At Wawanesa, we are committed to Diversity, Equity, Inclusion and Belonging (DEIB) and believe that our strength lies in the diversity of our people – this is supported by having a representative workforce.

We welcome applications from all qualified candidates, including racialised persons, women, Indigenous Peoples, persons with disabilities, members of the 2SLGBTQIA+ community, gender‑diverse and neurodiverse individuals, and anyone who can contribute to the further diversification of thought and ideas.

We aim to ensure our recruitment process is accessible to all candidates. If you require accommodations during any stage of the recruitment process, please reach out in confidence to [e-mail].

All Wawanesa job applicants are subject to Wawanesa's Privacy Policy.

Please note that the recruitment process for this position may involve the use of AI tools to screen, assess, or select applicants. All final decisions are taken or reviewed by human recruiters and human hiring leaders in compliance with all applicable legislation.