Claims Advisor - Accident Benefits

Peace Hills Insurance; Edmonton; On-site; CAD 65,000 - 90,000; Full time

Benefits offered by this job

Annual bonus eligibility

Pension plan matching

Personal insurance reimbursement

Work-life balance with day off every 4

Social events

Staff appreciation events

Professional development opportunities

Job summary

Peace Hills Insurance in Edmonton is seeking a Claims Advisor - Accident Benefits to join our team. You will handle Automobile and Accident Benefits claims from coverage discussion to settlement, reporting to the Claims Manager.

The role requires 3+ years of adjusting experience with Accident Benefits preferred, a post-secondary diploma, and strong negotiation and communication skills. Benefits include bonus eligibility, pension, personal insurance reimbursement, and a supportive culture.

Qualifications

• Minimum 3+ years adjusting experience in a similar role.
• At least 1 year Accident Benefits experience preferred.
• Post-secondary diploma or degree; CIP/FCIP designation is an asset.
• Ability to negotiate and critically analyze data and be decisive.

Responsibilities

• Confirm coverage and explain how it applies to reported claims.
• Investigate, evaluate, negotiate, and settle total loss claims.
• Determine liability.
• Explain the claims process to clients for auto and accident benefits.
• Obtain recorded statements.
• Collect and review medical documents and treatment plans.
• Obtain and verify employment information.
• Calculate benefit entitlements and authorize treatment with billing.
• Correspond with doctors, lawyers, treatment providers, employers and clients.
• Identify questionable claims and arrange MSEs/IMEs/IDEs.
• Liaise with Brokers and Underwriters.

Skills

Claims adjustment

Negotiation

Communication

Policy interpretation

Medical terminology

Time management

Interpersonal skills

Attention to detail

Guidewire

Education

Post-secondary diploma or degree

CIP/FCIP designation (asset)

Tools

Guidewire

Job description

We currently have an opening for a Claims Advisors - Accident Benefits in our Edmonton office. Reporting to the Claims Manager, this role involves the handling of both the Automobile and Accident Benefits portion of the claim, in most cases.

What You\'ll Do:

• Confirming and explaining coverage is in place and how it applies to reported claims;
• Investigating, evaluating, negotiating, and settling total loss claims;
• Determining liability;
• Explaining the claims process to clients for both automobile and accident benefits;
• Obtaining recorded statements;
• Collecting and reviewing medical documents and treatment plans;
• Obtaining and verifying employment information;
• Calculating benefit entitlements;
• Authorizing treatment and arranging appropriate billing with clients or providers;
• Corresponding with doctors, lawyers, treatment providers, employers, and clients;
• Identify questionable claims;
• Requesting and arranging MSE's, IME's and IDE's;
• Arranging for treatment at specialized facilities;
• Documenting activity on the file and issuing payments on a timely basis;
• Liaising with Brokers and Underwriters;
• Various other duties as required.

What You'll Bring:

• Minimum of 3+ years of adjusting experience in a similar role (with at least 1 year of Accident Benefits experience would be preferred);
• Post-secondary diploma or degree and/or working towards a CIP/FCIP designation would be considered and asset;
• Ability to negotiate and critically analyze data and be decisive;
• Familiarity with auto contract and laws applicable to Accident Benefits coverage;
• Awareness of medical terminology and medical abbreviations;
• Knowledge of common types of traumas, their treatments and recovery periods;
• Familiarity with human anatomy and physiology and the psychological consequences of trauma would be helpful in this position;
• Posses highly developed interpersonal, organizational and time management skills;
• Strong written and verbal communication skills;
• Guidewire experience is an asset.

What You’ll Experience:

• Competitive base pay with annual bonus eligibility;
• Healthy work-life balance including a day off every 4 weeks;
• Matching contributions to your Registered Pension Plan;
• Personal insurance reimbursement;
• Social events held throughout the year;
• Celebration of your team’s achievements each year with an annual staff appreciation event;
• A career in a stable and essential industry, at a company with an exceptional corporate culture and opportunities for professional development and advancement

Why Peace Hills:

Peace Hills General Insurance Company has been serving Western Canada since 1982 with home, auto and business insurance products. Our head office is in Edmonton, Alberta, with branch offices in Calgary and Vancouver. We currently employ over 300 staff who work withmore than 1,000 broker offices across British Columbia, Alberta, Saskatchewan, Manitoba, the Northwest Territories, Nunavut and Yukon Territory.

Peace Hills is proudly owned by the Samson Cree Nation, and it is through Wahkôtowin – a Cree word that means “kinship” and the interconnectedness of all beings – that we are and continue to be a respected insurer that provides creative and responsive solutions.

This job posting will remain open until a suitable candidate is found.