Claims Consultant Jobs

Opportunity:

Provides expertise and support to claims and underwriting functions and the insurance industry by giving advice to management, providing expertise to assist in the settlement of large and complicated claims files, organizing quality assurance activities, and providing assistance in the training of claims professionals and other special projects.

• Determine key measures to monitor service levels and effectiveness of Claims personnel.
• Assist with the interpretation of case law.
• Conduct periodic audits of claims files to ensure compliance with company standards, reporting results to the management team and using results toward efforts to improve Claims functions.
• Lead the development of technical claims training programs by assessing needs, developing content, and making recommendations.
• Provide Accident Benefits expertise to assist the Claims department in improving company guidelines and programs to effectively manage loss expenses and for the consistent application of claims settlement policies and procedures.
• Engage in special projects to examine the Claims function and develop ways to improve both processes and personnel to better serve customers, solve systemic problems and meet company goals.
• Provide consultation on large and complicated claims files, including technical guidance and advice to staff, assessment of exposure, facilitation of Alternative Dispute Resolution, and attendance at arbitration hearings as required.

What you bring:

• Ten years of relevant experience with Accident Benefits Claims.
• University degree or equivalent work experience.
• Detail oriented.
• Excellent problem-solving and analytical skills.
• Flexible with the ability to work in a constantly changing environment.
• Experience and or knowledge of Alternate Dispute Resolution.
• Technical expertise in claims management with particular emphasis on accident benefits claims, and extensive experience in coverage analysis, investigation, and quantum evaluation.