Sr Representative, Accidents Benefits Claims

Definity; Calgary; Hybrid; CAD 59,000 - 109,000; Full time

Benefits offered by this job

Company share ownership program

Pension and RRSP matching

Hybrid work schedule

Volunteer days

Job summary

Definity is seeking an experienced Accident Benefits professional to manage a diverse portfolio of claims including income replacement, non-earner, caregiver, and impairment benefits. You will assess coverage, coordinate rehabilitation, and ensure fair, compliant claims handling.

Reporting to the Team Leader, Accident Benefit Claims, you will communicate with customers and healthcare providers, review policy wordings, apply priority rules, and process payments and reserves in a busy, supportive

Qualifications

• University degree in any discipline or a college diploma or the CIP designation.
• Minimum of 4 years Claims handling experience.
• Computer proficiency in MS Word and Excel.
• Strong written and verbal communication skills.

Responsibilities

• Investigate, evaluate benefits, and administer Care First in accordance with the Insurance Act.
• Secure details of claims by corresponding with customers, care practitioners, and/or representatives.
• Regular communication with the customer and their health care practitioner(s).
• Assess coverage eligibility and review interpretations of policy wordings for resolution of coverage issues.
• Apply Priority Rules chart to each claim file.
• Process out of province and election of benefit claims.

Skills

Communication

Customer service

Teamwork

Stress management

Problem solving

Education

University degree / college diploma or CIP designation

Tools

MS Word

Excel

Job description

The Opportunity

This opportunity is well suited for an experienced Accident Benefits professional who thrives in a fast-paced environment and is committed to delivering exceptional customer service. Reporting to the Team Leader, Accident Benefit Claims, you will be responsible for managing a diverse and complex portfolio of claims, including income replacement, non-earner, caregiver, permanent impairment, and fatality benefits. Working closely with customers, healthcare practitioners, and other stakeholders, you will assess coverage eligibility, facilitate rehabilitation and recovery, and ensure claims are administered fairly, accurately, and in compliance with the Insurance Act and Care First principles.

Job Description

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 practitioners, 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 out of province and election of benefit claims


• Processing income replacement, non-earner, loss of studies, caregiver, permanent impairment, fatality, and other 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 and approving, when appropriate, treatment plans for customer rehabilitation


• Arranging medical assessments as necessary and reviewing and relaying recommendations


• Other duties as assigned

What You Bring

• University degree in any discipline or a college diploma or the CIP designation


• Minimum of 4 years Claims handling experience


• Computer proficient in MS Word and Excel


• Professional, friendly and courteous in all interactions, whether with customers or co-workers


• 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:

$59,300 - $109,200

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.

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

Go ahead and expect a lot — you deserve it.

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.

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.