Int Representative, Accident Benefits Claims

Definity; Calgary; Hybrid; CAD 51,000 - 94,000; Full time

Benefits offered by this job

Hybrid work schedule

Pension and RRSP contributions

Paid volunteer days

Tuition assistance

Job summary

Definity is seeking a claims professional to investigate and adjudicate accident benefit claims, coordinating with customers and health care practitioners to ensure timely and fair resolution. The role reports to the Team Leader, Accident Benefit Claims and operates within the Care First framework.

Requirements include a university degree or CIP designation and 2–3 years of claims experience, with proficiency in MS Word and Excel. Hybrid work setup and strong communication skills are valued.

Qualifications

• University degree, college diploma in related field or the CIP designation.
• Minimum 2-3 years of claims handling experience.
• Proficient in MS Word and Excel.
• Professional, friendly and courteous in all interactions.

Responsibilities

• Investigate and adjudicate claims, determine benefit entitlement, and deliver service.
• Coordinate treatment plans with customers and health care practitioners.
• Assess coverage eligibility and interpret policy wordings.
• Process income replacement benefits and reserve files as needed.
• Maintain detailed file records on an electronic claims system.

Skills

MS Word

MS Excel

Customer service

Communication

Education

University degree or CIP designation

Tools

MS Excel

MS Word

Job description

The Opportunity

This role is ideal for a customer-focused claims professional who is passionate about supporting individuals through the accident benefits claims process. Reporting to the Team Leader, Accident Benefit Claims, you will be responsible for investigating and adjudicating claims, determining benefit entitlement, and delivering exceptional service in accordance with the Insurance Act and the organization’s Care First principles. The successful candidate will work closely with customers, healthcare practitioners, and other stakeholders to coordinate treatment plans, manage claim files, and ensure timely, fair, and accurate claim resolution.

What To Expect

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating benefits, and administering the principles of Care First in accordance with the Insurance Act
• Securing details of claims by corresponding with customers, care practitioner(s), and/or representatives
• Regular communication with the customer and their health care practitioner(s)
• Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
• Applying applicable Priority Rules chart to each claim file
• Processing income replacement benefits
• Reserving files appropriately after assessing claim
• Maintaining detailed file records on an electronic claims system
• Processing payments after confirming benefits, eligibility and reserves
• Coordinating the most effective course of action for claims
• Confirming collateral benefits
• Responding to customer correspondence and forms in accordance with the applicable legislation
• Reviewing Programs of Care treatment plans for customer rehabilitation and other treatments and benefits as appropriate
• Arranging medical assessments as necessary and reviewing and relaying recommendations
• Other duties as assigned

What You Bring

• University degree, college diploma in related field or the CIP designation
• Minimum 2-3 years of claims handling experience
• Proficient in MS Word and Excel
• Professional, friendly and courteous in all interactions, whether with customers or co-workers
• Able to perform well in a busy operation and remain calm under pressure
• Team player adaptable to a changing environment
• Strong written and verbal communication skills

Salary Range

$51,300 - $94,400

About Us

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market.

This position is being posted to fill an existing vacancy.

It’s better here — but don’t take our word for it. Definity was named by Great Place to Work® as one of the Best Workplaces™ in Canada for women, for youth, and for inclusion.

Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting [e-mail].

As part of Definity’s commitment to reconciliation, we acknowledge that our work, meetings, and travel take place on the lands now known as Canada, and recognize the enduring presence, wisdom, and stewardship of the First Nations, Métis, and Inuit peoples who have long cared for these lands.

What's in it for you?

• Hybrid work schedule for most roles
• Company share ownership program
• Incentive Program - Eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
• Pension and savings programs, with company-matched RRSP contributions
• Paid volunteer days and company matching on charitable donations
• Educational resources, tuition assistance, and paid time off to study for exams
• Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
• Wellness and recognition programs
• Discounts on products and services

Background checks

This role requires successful clearance of background checks (including criminal checks and leadership references).

About The Team

Definity is the parent company to some of Canada’s most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. Our ambition is to be one of Canada’s leading and most innovative property and casualty insurers. We can’t do that without our people, so we embrace and encourage a culture that’s collaborative, ambitious, rewarding, and empowering. We offer a flexible, hybrid work experience where employees work from the office and virtually depending on the type of work they are doing and who they are working with. Bring your true self and be a part of our journey. It’s better here.