Hybrid Creditor Life & Disability Claims Examiner III

Co-operators Career; New Jersey; Hybrid; USD 54,000 - 65,000; Full time

Benefits offered by this job

Training and development opportunities

Paid time off

Volunteer days

Total rewards package

Job summary

The CUMIS Union in Canada is seeking a Claims Examiner III for Creditor Life and Disability to adjudicate a caseload of GMP and Monthly Premium disability and life claims with a focus on minimizing disability durations. This role involves reviewing medical information, determining eligibility for benefits, and developing proactive case management plans.

You will work in a hybrid environment (2 days in office) within the Creditor Claims department, collaborating with teams to support clients and

Qualifications

• Post-secondary diploma with 2 years customer service experience; 2 years disability claims management preferred.
• Medical anatomy college/university equivalent or ICA CI required.
• Completion of LOMA 280 & 290 required.
• ALHC or related degree preferred.
• Knowledge of creditor products.

Responsibilities

• Review current and historical medical information to assess misrepresentation in applications.
• Communicate misrepresentation or rescission decisions to policyholders and parties.
• Ensure accuracy of information supported by new claims.
• Interview claimants, employers, and loan officers by phone before decisions.
• Determine if a claim is payable using available information and policy provisions.
• Develop and execute proactive case management plans to minimize disability duration.
• Initiate assessments and examinations when necessary.
• Assess change of definition and communicate decisions.

Skills

Customer service

Disability claims management

Communication skills

Team player

Education

Post-secondary diploma

Medical anatomy

LOMA 280

LOMA 290

ICA CI

ALHC

Job description

The CUMIS Union in Canada is seeking a Claims Examiner III for Creditor Life and Disability to adjudicate a caseload of GMP and Monthly Premium disability and life claims with a focus on minimizing disability durations. This role involves reviewing medical information, determining eligibility for benefits, and developing proactive case management plans.

You will work in a hybrid environment (2 days in office) within the Creditor Claims department, collaborating with teams to support clients and