Senior Accident Benefits Claims Adjuster

The Commonwell Mutual Insurance Group; Canada; On-site; CAD 80,000 - 100,000; Full time

Job summary

A mutual insurance company is seeking a Senior Accident Benefits Claims Adjuster to handle complex claims and ensure compliance with insurance policies. The role involves analyzing and negotiating claims within personal authority, requiring at least seven years of experience in insurance and a strong educational background. This remote position emphasizes leadership, ethics, and excellent problem-solving skills.

Qualifications

• Minimum of seven years of experience in insurance, specifically in accident benefits.
• Working towards or completion of CIP designation.
• Ability to handle complex claims with expertise.

Responsibilities

• Review and negotiate complex Accident Benefit claims.
• Interpret insurance policies and determine coverage.
• Set reserves on claims and handle settlements.

Skills

Leadership and mentoring

Problem-solving

Negotiation

Computer literacy

Confidentiality and ethics

Education

Post-Secondary Education

Tools

Microsoft Office

Job description

Senior Accident Benefits Claims Adjuster

Join to apply for the Senior Accident Benefits Claims Adjuster role at The Commonwell Mutual Insurance Group

Job title: Senior Accident Benefits Claims Adjuster (ON)

Job Location: Remote

Here at The Commonwell, we are all about Protecting Individuals, Together! Our vision is to continue to build an environment that develops and attracts the very best by empowering everyone to foster a workplace where everyone can perform at their very best, be their authentic self and bring their whole self to work.

The Opportunity

The purpose of this position is to review, analyze, evaluate and negotiate complex and catastrophic claims related to Accident Benefit claims. As well as interpret insurance policy wording, determine policy coverages and set reserves on Accident Benefit claims.

Who You Are

• Exemplifies the necessary skills to support and lead, where required, the technical development of staff within the claims department through training and mentorship
• Active working relationships with all functional units of the organization

How You Will Create An Impact

The expectation for this role is that the incumbent has attained the relevant technical knowledge that is required to handle complex and catastrophic claims including the following:

• Expert knowledge of all relevant regulations, including the Statutory Accident Benefit Schedule and the Insurance Act
• Expert competency in reading and interpreting all policy wordings relevant to claims assigned
• Expert competency in comprehension of reserve calculations and exposure
• Expert competency and knowledge with LAT’s and claims resolution processes.
• Expert demonstration of interpretation and understanding of Insurer’s Examination reports
• Accountable for claims at all transaction levels including, coverage interpretation, evaluation, reserve adjustments, payments, written and verbal communication, expert requirements and internal reporting requirements
• Settlement of claims within personal authority and follow company guidelines on claims exceeding personal authority

What You Will Bring

• Completion of Post-Secondary Education and a minimum of seven years of insurance, in accident benefits is required
• Working towards, or completion of CIP, and an active pursuer of the necessary education to respond to a changing marketplace
• Sound morals, ethics and confidentiality with ability to develop trusting and effective working relationships with peers and employees
• Demonstrated ability to exercise confidentiality and empathy are required when dealing with insured’s and claimants
• Superior problem solving and negotiation are required
• Strong computer literacy, proficiency in all Microsoft Office programs and internet navigation

Accommodations: The Commonwell is an equal opportunity employer committed to ensuring barrier free employment practices. Should you require accommodations throughout the recruitment process, please let us know, and we will work with you to meet your needs.