Claims Advisor, Accident Benefits

Desjardins; Mississauga; Hybrid; CAD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary with annual bonus

4 weeks flexible vacation

Defined benefit pension plan

Group insurance including telemedicine

Reimbursement of health and wellness

Job summary

Desjardins Ontario is seeking skilled Accident Benefits Claims professionals to manage mid to high complexity claims with a focus on functional recovery and client satisfaction. You will guide clients through the claims process, communicate updates, and collaborate with medical and legal partners to achieve fair outcomes.

With a Bachelor’s degree and at least three years of accident benefits experience, you will assess regulatory obligations, apply reserving practices and ensure timely claim

Qualifications

• Bachelor's degree required in a related field.
• CIP designation or enrollment in CIP program preferred.
• At least 3 years of experience in accident benefits claim handling.
• Advanced knowledge of Statutory Accident Benefits Schedule and related terminology.

Responsibilities

• Investigate, evaluate and negotiate accident benefit claims of moderate to high complexity.
• Maintain clear and timely communication with clients about claim status.
• Manage disability claims with focus on functional recovery and return to work.
• Collaborate with medical professionals, legal representatives and rehabilitation providers.
• Apply accurate reserving practices and ensure timely payments.

Skills

Customer focus

Decision quality

Interpersonal Savvy

Tech savvy

Equity Diversity Inclusion

Education

Bachelor's degree in a related field

CIP designation or enrolled in the program

Job description

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
• 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.

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

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)

#LI-Hybrid, #ON08

Desjardins Group is the largest cooperative financial group in North America. We're the choice for over 52,000 employees and we're named one of Canada's top employers by Mediacorp and Forbes. We offer a full range of financial products and services and share our expertise in personal services, business services, wealth management, life and health insurance, and property and casualty insurance. Pursuing a career at Desjardins means being part of an organization that puts people first.