Medical Claims Processor

7 days ago


Toronto, Ontario, Canada Allstate Canada Full time

Allstate Insurance Company of Canada is a leading home and auto insurer focused on providing its customers prevention and protection products and services for every stage of life.

The company is proud to have been named a Best Employer in Canada for nine consecutive years and prioritizes supporting employees and fostering an inclusive, welcoming corporate culture.

Allstate is committed to making a positive difference in the communities in which it operates through partnerships with charitable organizations, employee giving and volunteerism.

Through our Employee Value Proposition, Opportunity, Flexibility, Community, Diversity and Family, we have worked hard to develop and nurture a culture where employees feel valued, experience personal growth, have career options and truly enjoy the work they do.

Flexible Work Arrangements
Good Office program (receive up to $400 back after purchasing office equipment)
Comprehensive Retirement Savings Program with employer matched contributions
Working within the community and giving back

Our team is growing, and we are actively looking to hire a Senior Claim Advisor, Accident Benefits to join our Ontario team Reporting to the Manager Casualty Claims Complex AB, you will be accountable for handling complex first party injury claims.


Role Designation :
Home-Based (Alberta, Ontario, Quebec, Nova Scotia or New Brunswick with Ontario region experience)

Interpret insurance policy wording, determine policy coverages and set reserves on Accident Benefit claims assigned
Investigate, negotiate and settle accident benefits claims or moderate to high complexity by telephone, in person and/ or by written correspondence
Comply with best practices as set out in Allstate policies and procedures
Adhere to legislative and regulatory requirements
Settlement of claims within personal authority and follow company guidelines on claims exceeding personal authority
Maintain a caseload reflective of a Senior Claim Advisor, Accident Benefits
Communicate and interact with claimants, vendors, medical professionals, lawyers in a professional manner
Work collaboratively with a team of Accident Benefit Adjusters and Claims Assistants
Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred
Strong critical thinking skills to identify strengths and weaknesses of claim
Allstate Canada Group has policies and practices that provide workplace accommodations.
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