Int Representative, Claims Accident Benefits

Starr Underwriting; Toronto; On-site; CAD 50,000 - 93,000; Full time

Job summary

A leading company in insurance is seeking an Accident Benefit Claims Adjuster to investigate and settle claims under the Insurance Act. This role requires strong communication skills and the ability to manage multiple responsibilities effectively. Ideal candidates should have a related university degree or college diploma and experience in claims handling.

Qualifications

• Minimum 2-3 years of claims handling experience.
• Proficient in MS Word and Excel.
• Strong written and verbal communication skills.

Responsibilities

• Investigating, evaluating and settling Accident Benefit claims.
• Assessing coverage eligibility and processing payments.
• Maintaining detailed file records on an electronic claims system.

Skills

Communication

Customer Service

Teamwork

Organizational Skills

Education

University degree or college diploma in related field

CIP designation

Tools

MS Word

Excel

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 related field or the CIP designation
• Minimum 2-3years ofclaims 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 $50,200 - $92,500