Int Representative, Claims Accident Benefits

Definity Financial Corporation; Mississauga; On-site; CAD 48,000 - 90,000; Full time

Job summary

Join a forward-thinking company as a Claims Adjuster, where you'll play a crucial role in investigating and settling Accident Benefit claims. In this dynamic position, you'll collaborate with a dedicated team to ensure claims are handled efficiently and in accordance with the Insurance Act. Your expertise will help assess coverage eligibility, process various claims, and maintain detailed records on our electronic system. This is an excellent opportunity for someone with a strong background in claims handling and a passion for providing exceptional customer service. If you thrive in a fast-paced environment and enjoy problem-solving, this role is perfect for you.

Qualifications

• 2-3 years of claims handling experience required.
• University degree or college diploma in a related field preferred.

Responsibilities

• Investigate, evaluate, and settle Accident Benefit claims.
• Maintain detailed file records on an electronic claims system.
• Process payments and confirm benefits eligibility.

Skills

Claims Handling

Communication Skills

MS Word

MS Excel

Customer Service

Adaptability

Education

University Degree

College Diploma

CIP Designation

Job description

Reporting to the Team Leader, Accident Benefit Claims, you are accountable for investigating, evaluating, and settling Accident Benefit claims.

What can you expect in this role?

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating, and settling accident benefit claims in accordance with the Insurance Act.
• Securing details of claims by corresponding with claimants and/or representatives.
• 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, non-earner, and attendant care claims.
• 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 claimant correspondence and accident benefit forms in accordance with the applicable legislation.
• Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation.
• Arranging insurer examinations to determine benefits eligibility.
• Preparing referral packages and obtaining the necessary medical information for insurer examinations.
• Responding to assessment recommendations.
• Other duties as assigned.

What do you bring to the role?

• University degree, college diploma in a 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 is $48,700 - $89,800.