Senior Accident Benefits Claims Advisor

Sécurité Nationale Compagnie d'Assurance; Markham; On-site; CAD 60,000 - 80,000; Full time

Job summary

A leading insurance company in Canada is looking for an Analyst specializing in Accident Benefits to manage complex claims and ensure client needs are prioritized. This role demands strong negotiation and conflict resolution skills, along with a robust understanding of Accident Benefit processes. Candidates must have a minimum of three years of experience and proficiency in Microsoft Office applications. A competitive total rewards package will be offered.

Benefits

Health and well-being benefits

Paid time off

Career development programs

Qualifications

• Proficient in case managing complex Accident Benefit claims.
• Experience handling files with moderate complexity.
• Ability to analyze and prepare documents, reports, and correspondence.

Responsibilities

• Act urgently to identify and meet client needs regarding claims.
• Manage case handling of complex claims including payment priorities.
• Ensure timely and accurate reserves for claims.

Skills

Handling of Accident Benefits claims

Strong Negotiations Skills

Conflict resolution

Time management

Effective communication

Education

3+ years in relevant claims management

Tools

MS Word

Excel

Job description

Description

Reporting directly to a Team Manager, key responsibility of the Analyst, Accident Benefits, is to act with a sense of urgency in identifying and meeting client needs. This includes ensuring timely & thorough investigation of claims involving predominantly complex issues and / or high exposures, identifying client eligibility and / or entitlement, and ensuring quick access to all available benefits to promote treatment and recovery, and to help the client return to optimal function.

Responsible for case handling of claims involving more complex issues and / or high exposures including priority of payment, commercial & loss transfer and loss reserving, WSIB, and non-MIG / Non-CAT exposures.

Ensure accurate and timely reserves and take a total cost management approach to claims.

Job Requirements :

3+ years handling of Accident Benefits claims involving more complex issues and / or high exposures including priority of payment, commercial & loss transfer and loss reserving, WSIB, and non-MIG / Non-CAT Exposures

Proven ability to handle complex (Non-MIG, Non-CAT) Exposures

Effective management of claims with a total incurred over $50,000, files with moderate complexity.

Strong Negotiations Skills

Proven ability to resolve customer escalations in a fair and timely manner.

You have experience in case managing complex Accident Benefit claims with your exceptional technical skills.

You listen and respond with authority and compassion.

You are dedicated to and have a proven ability to communicate effectively and interact successfully with internal and external clients.

You have demonstrated leadership skills.

You are a proficient time manager.

You recognize discrepancies and / or gaps in data and reports and use effective questioning techniques.

You negotiate win / win outcomes when possible.

You write clear and professional letters conveying appropriate type and amount of information.

You effectively interpret the standard auto policy, particularly the SABS.

You effectively interpret medical documents and have advanced knowledge of the human anatomy.

You have above average knowledge and experience with the MS Word / Excel.

You understand the need for accuracy and meeting deadlines.

Additional Information

• Ability to process and handle confidential information with discretion
• Ability to analyze, organize and prioritize work while meeting multiple deadlines
• Ability to set priorities and complete assignments on time
• Skill in conflict resolution and negotiation skills to collaborate across internal and / or external groups / partners
• Skill in persuading or influencing others
• Skill in negotiation and facilitation
• Skill in negotiating by bringing others together and reaching a consensus
• Skill in managing one's own time and the time of others
• Skill in completing assignments accurately and with attention to detail
• Skill in encouraging and building mutual trust, respect, and cooperation among team members
• Ability to work under pressure and meet required deadlines
• Ability to analyze and prepare documents, reports and correspondence
• Ability to provide guidance and expert advice to management or other groups on technical, systems or process related topics

LI-TDI

IN-TDI

Who We Are :

As part of TD Bank Group, one of Canada's largest financial institutions, at TD Insurance, we care for Canadian families, making it easy to get the best advice, protection, and support in their moments of need, always.

TD Insurance offers a wide range of products, including General Insurance and Life and Health. More than four million customers count on us.

As the largest direct to consumer insurer in Canada, we are always innovating and providing exciting and rewarding career opportunities for our Canada-wide workforce.

Our Total Rewards Package

Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial, physical, and mental well-being goals. Total Rewards at TD includes a base salary, variable compensation, and several other key plans such as health and well-being benefits, savings and retirement programs, paid time off, banking benefits and discounts, career development, and reward and recognition programs.

Additional Information :

We’re delighted that you’re considering building a career with TD. Through regular development conversations, training programs, and a competitive benefits plan, we’re committed to providing the support our colleagues need to thrive both at work and at home.

Please be advised that this job opportunity is subject to provincial regulation for employment purposes. It is imperative to acknowledge that each province or territory within the jurisdiction of Canada may have its own set of regulations, requirements.

Colleague Development

If you’re interested in a specific career path or are looking to build certain skills, we want to help you succeed. You’ll have regular career, development, and performance conversations with your manager, as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities. Whether you have a passion for helping customers and want to expand your experience, or you want to coach and inspire your colleagues, there are many different career paths within our organization at TD – and we’re committed to helping you identify opportunities that support your goals.

Training & Onboarding

We will provide training and onboarding sessions to ensure that you’ve got everything you need to succeed in your new role.

Interview Process

We’ll reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call.

Accommodation

Your accessibility is important to us. Please let us know if you’d like accommodations (including accessible meeting rooms, captioning for virtual interviews, etc.) to help us remove barriers so that you can participate throughout the interview process.

We look forward to hearing from you!

Language Requirement (Quebec only) :

Sans Objet