Claims Advisor, Accident Benefits

Desjardins; Burlington; On-site; CAD 67,000 - 98,000; Full time

Benefits offered by this job

Competitive salary

Annual bonus

Defined benefit pension

Telemedicine

Health and wellness expense reimburse

Telework equipment

Job summary

Desjardins Ontario seeks experienced Accident Benefits Claims professionals to manage moderate to high complexity claims with a strong focus on functional recovery and client satisfaction. You will guide clients through the claims process, investigate, evaluate and negotiate benefits, and maintain relationships with members and clients for timely resolutions.

The role requires collaboration with medical professionals, legal representatives, and rehabilitation providers to support recovery and

Qualifications

• Bachelor's degree in a related field.
• A minimum of three years of relevant experience in accident benefits claim handling.
• Please note that other combinations of qualifications and relevant experience may be considered.
• Intermediate experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery and return to work.
• 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

Responsibilities

• Investigate, evaluate and negotiate accident benefit claims of moderate to 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 Disability claims with a keen focus on functional recovery and return to work
• Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well‑being
• 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.

Skills

Action oriented

Business insight

Complexity

Customer focus

Decision quality

Interpersonal savvy

Nimble learning

Tech savvy

Education

Bachelor's degree

Tools

CIP designation

Job description

Benefits

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professionals, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. In this role, you will manage accident benefit claims of moderate to high complexity, with a strong focus on functional recovery, client satisfaction and stakeholder collaboration. You will play a critical role in guiding clients through the claims process, ensuring their unique needs are met with professionalism and empathy. You will investigate, evaluate and negotiate accident benefits claims, while establishing and maintaining relationships with members and clients. 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 moderate to 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 Disability claims with a keen focus on functional recovery and return to work
• Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well‑being
• 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.

Benefits

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professionals, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. In this role, you will manage accident benefit claims of moderate to high complexity, with a strong focus on functional recovery, client satisfaction and stakeholder collaboration. You will play a critical role in guiding clients through the claims process, ensuring their unique needs are met with professionalism and empathy. You will investigate, evaluate and negotiate accident benefits claims, while establishing and maintaining relationships with members and clients. 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 moderate to 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 Disability claims with a keen focus on functional recovery and return to work
• Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well‑being
• 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 : $66 971 to $98 225 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.

, #ON08*

What You Bring To The Table

• Bachelor's degree in a related field
• A minimum of three years of relevant experience in accident benefits claim handling
• Please note that other combinations of qualifications and relevant experience may be considered
• Intermediate experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery and return to work.
• 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, Tech savvy

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!

Trade Union (If applicable)

Job Family

Member/client sales and service (FG)

This position is actually vacant.

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