Claims Examiner

CRC Group; Toronto; On-site; CAD 60,000 - 80,000; Full time

Job summary

A leading insurance firm is seeking a Claims Administrator in Toronto to manage and evaluate claims related to life, disability, and job loss. This position requires fluency in both French and English and a minimum of 5 years of experience in claims administration. The successful candidate will ensure compliance with policy terms, maintain documentation, and communicate effectively with clients and management. Eligibility for various employee benefits, including healthcare and a retirement plan, is offered.

Benefits

Medical and dental insurance

401k plan

Minimum 10 vacation days per year

Paid holidays

Sick days

Qualifications

• At least 5 years’ experience in claims administration in the life insurance industry.
• Fluently bilingual in French and English.
• Experience dealing with medical professionals required.

Responsibilities

• Investigate and evaluate the eligibility of life, disability and job loss claims.
• Ensure communication and documentation of claims is accurate and timely.
• Provide claims administrative support to other departments when needed.

Skills

Excellent communication

Interpersonal skills

Analytical skills

Problem-solving

Decision-making

Microsoft Office Word

Education

Completion of LOMA Levels 1 and 2

Job description

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one.

If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response).

Regular or Temporary:

Regular

Language Fluency: English (Required)

Work Shift:

1st Shift (Canada)

Please review the following job description:

Reporting to the Director, Insurance Solutions, you will investigate and evaluate the eligibility of life, disability and job loss claims.

KEY RESPONSIBILITIES

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

Ensure accurate and timely investigation, evaluation, and eligibility of life, disability, and job loss claims based on medical information, job requirements, non-medical factors, and policy terms within established service standards and operating protocols.

Communicate decisions and recommendations to management and clients.

Ensure accurate and timely documentation of all communication with customers.

Collaborate with management to exchange ideas, gather information, and offer solutions on claims.

Ensure proactive communication with policyholders regarding claim status and developments.

Provide claims administrative support to other departments when required

EDUCATION AND EXPERIENCE

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

At least 5 years’ experience in claims administration in the life insurance industry (required)

Fluently bilingual in French and English (required)

Experience dealing with medical professionals (required)

Prior experience working with creditor insurance products (preferred)

LOMA courses – completion of Levels 1 and 2 (preferred)

CERTIFICATIONS, LICENSES, REGISTRATIONS

None

FUNCTIONAL SKILLS

Excellent communication (oral and letter writing), interpersonal, and collaboration skills

Strong analytical, problem-solving, and decision-making skills

Ability to interact with clients and other stakeholders at all levels

Ability to prioritize and multitask

Strong Microsoft Office Word skills

Willingness to take industry courses

General Description of Available Benefits for Eligible Employees of CRC Group: All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of CRC Group offering the position.CRC Group offers medical, dental, vision, life insurance, disability, accidental death and dismemberment, tax-preferred savings accounts, and a 401k plan to teammates. Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays. Depending on the position and division, this job may also be eligible for restricted stock units, and/or a deferred compensation plan. As you advance through the hiring process, you will also learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work.

CRC supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC is a Drug Free Workplace.

EEO is the LawPay Transparency Nondiscrimination ProvisionE-Verify