Accident Benefits Claims Examiner Jobs

4+ years of Accident Benefit Adjusting experience required.

Post secondary education (University Degree or College Diploma) in Business, Health Sciences, or related field is preferred.

ADR and Litigation including LAT experience is an asset.

Knowledge of medical and legal information and terminology.

CIP Designation or working toward completion

An advanced level of English (Verbal and written) is required.

Strong time management and organizational skills as well as the ability to work in a fast-paced environment

Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred

Interpret insurance policy wording, determine policy coverages and set reserves on Accident Benefit claims assigned

Investigate, negotiate and settle accident benefits claims of moderate complexity by telephone, in person and/ or by written correspondence

Adhere to legislative and regulatory requirements

Maintain a caseload reflective of a Claim Advisor, Accident Benefits

Must have excellent written and verbal communication skills

Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts

Conduct telephone calls to health and dental service providers for incomplete claims information

Make accurate payment decisions according to adjudication guidelines

Living our values of Customer View; Integrity; Partnership; and Communities

Minimum keyboarding speed of 40 wpm, must be able to handle large volumes of work with a high level of accuracy

Excellent benefits and compensation package

Must have excellent written and verbal communication skills as well as great analytical skills

Permanent, direct hire with the organization

Work-life balance, 37.5 hours per week

Well-known employer with great company culture

Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts

Excellent benefits and compensation package

Must have excellent written and verbal communication skills as well as great analytical skills

Permanent, direct hire with the organization

Work-life balance, 37.5 hours per week

Well-known employer with great company culture

Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts

Excellent benefits and compensation package

Must have excellent written and verbal communication skills as well as great analytical skills

Permanent, direct hire with the organization

Work-life balance, 37.5 hours per week

Well-known employer with great company culture

Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts

To appropriately handle accident benefits claims according to individual authority, knowledge and expertise.

2 - 3 years of insurance claims handling experience (Accident Benefits experience)

College Diploma/ Associate Degree or similar experience

Post-secondary Education (College Diploma or Bachelor Degree) in related field.

Compelling rewards package including base compensation, eligibility for annual bonus, retirement savings, share plan, health benefits, personal wellness, and volunteer opportunities.

We’ll support your professional development education.

Excellent time management and organizational skills with the ability to prioritize work in a fast paced, changing environment.

Excellent investigative and analytical skills. Detail oriented with a high degree of accuracy regarding data entry.

Adjustment of Accident Benefit claims of low to moderate complexity.

Coordinate and manage services with vendors and service providers such as accountants, lawyers, rehabilitation clinics and health practitioners.

Exceptional customer service skills demonstrating empathy and concern for member satisfaction.

1 year of insurance adjusting experience or equivalent.

Competitive Benefits, including RRSP contributions, medical and dental

Must have excellent written and verbal communication skills in English and French

Salary: $40,000 - $50 000 annually

Schedule: 37.5 hours per week

Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts

Conduct telephone calls to health and dental service providers for incomplete claims information

Post-secondary education and / or equivalent on the job experience

Strong analytical, problem-solving skills, investigative, and decision-making skills.

Demonstrated report-writing skills, including an orientation toward detail and precision.

Able to plan, organize, and manage multiple demands and changing priorities.

Strong leadership skills and interpersonal skills.

Excellent communication (both oral and written) skills to explain processes and terms.

Accountable for the management and oversight of significant indemnity reserves and spend for the LOB

Support the development/refinement of appropriate metrics, dashboards and financial/nonfinancial KPIs to enable effective performance management

Ensure a focus on expense management

Possess strong influencing skills leadership capabilities

Sound understanding of financial, strategic and performance management processes

Performance Measurement and Management Control

Post-secondary education or equivalent experience

Manage challenging coverage claims with tact and professionalism

Obtain approval from Manager on claims above authority

Manage claims in litigation, participate in mediations, pre-trials and settlement conferences

Perform other tasks and duties as assigned by the Manager

Minimum of 7 years experience handling casualty claims required

To appropriately handle accident benefits claims according to individual authority, knowledge and expertise.

1 - 3 years of Accident Benefits insurance claims handling experience

College Diploma/ Associate Degree or similar experience

Post-secondary Education (College Diploma or Bachelor Degree) in related field.

Compelling rewards package including base compensation, eligibility for annual bonus, retirement savings, share plan, health benefits, personal wellness, and volunteer opportunities.

We’ll support your professional development education.

Strong time management and organizational skills

Adjudicate claims according to various benefit policies

Minimum 2-3 years of relevant travel insurance or medical insurance claims processing experience

Strong analytical and problem-solving skills

Superior verbal and written communication skills in English and/or French

Snowbird, expatriate insurance, TPA experience

Processing payments after confirming benefits, eligibility and reserves

Responding to claimant correspondence and accident benefit forms in accordance with the applicable legislation

Arranging insurer examinations to determine benefits eligibility

Minimum 2-3 years of claims handling experience

Strong written and verbal communication skills

Educational resources, tuition assistance, and paid time off to study for exams

Job Requirements (Education, Experience, Knowledge, Skills And Proficiencies)

You will have adjudication knowledge and experience

Create a white glove customer experience for our Claimants

Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.

Make decisions on claim benefit eligibility determination and communication decisions to stakeholders

University degree in any discipline or equivalent work experience.

Ensure superior customer service experience

Minimum post-secondary education or equivalent

Have a medical background and experience working in a medical environment

Claim Advisor, Accident Benefits MIG (Minor Injury Guideline)

Employee discounts (15% on auto and property insurance, plus many other products and services)

Good Office program (receive up to $400 back after purchasing office equipment)

• Maintain professional and technical knowledge by participating in educational opportunities.

• Confirm policy existence by identifying coverage on low complexity claims.

• Establish timely reserves within authority limit by estimating value of claims.

• Ensure customer service by proactively communicating information, responding to inquiries, and following customer protocols.

• Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud.

• Collect data and document in established system to facilitate the accurate assessment and value of claims.

• Strong organizational and time management skills coupled with strong decision-making skills

To appropriately handle accident benefits claims according to individual authority, knowledge and expertise

• Through knowledge of the legislation that governs these benefits (SABS)

• Investigation, evaluation, negotiation and settlement and administration of all accident benefit claims

• Minimum of 2-3 years claims handling experience

• Excellent customer service and interpersonal skills

Experience (1-2 years) with data entry or data processing large volumes of information

Excellent benefits and compensation package

Must be with excellent communication skills

High attention to detail, organizized and demonstrates analytical and problem solving skills

Excellent ability to manage multiple priorities and achieve deadlines

Permanent, direct hire with the organization