Claims Specialist

2 weeks ago

Lindsay, Ontario, Canada The Commonwell Mutual Insurance Group Full time

Job Title:
Claims Specialist Level - Accident Benefits

Job Location:
Remote
Join our Team


The purpose of this position is to review, analyze, evaluate, and negotiate minor to moderate claims related to Accident Benefits.

What you will do as part of the team:

  • Accountable for claims at all transaction levels including, coverage interpretation, evaluation, Reserve adjustments, payments, written and verbal communication, expert requirements, and internal reporting requirements
  • Consults as required for authority requests with respect to payments, settlements, and incurred handling.

What you will need to succeed:

  • Completion of College Diploma or University degree and a minimum of five years of insurance, preferably in claims is required
  • Working towards or completion of Certified Insurance Professional designation is required
  • Great organizational skills and ability to multitask is required
  • Thorough attention to detail is a must to ensure accuracy of claims documents
  • Proficient mathematical skills are required with the ability to perform complex calculations when determining payable benefits
  • Effective communication skills: verbal, nonverbal and written
  • Sound morals, ethic, and confidentiality with ability to develop trusting and effective working relationships with peers and employees
  • Ability to exercise confidentiality and empathy are required when dealing with
- insured's and claimants

  • Strong problemsolving skills and negotiation skills are required for this position
  • Strong computer literacy, proficiency in all Microsoft Office programs and Internet navigation.
  • Working knowledge of benefit entitlement as well as priority, loss transfer and WSIB issues
  • Working knowledge of the Statutory Accident Benefits Schedule
  • Working knowledge and ability of reading and interpreting all relevant policy wordings including the OAP, and most OPCF endorsements
  • Working comprehension of reserve calculation and exposures
  • Working knowledge of reinsurance restrictions of reinsurance treaty
  • Proficient knowledge of other relevant regulations, including the Insurance Act, WSIB and case law decisions requiring some support in interpretation
  • Proficient demonstration of interpretation and understanding of medical terminology and prognosis
  • Understanding and ability to participate in LAT's
JOIN THE
#Commonwell Crew We saved you a spot

Accommodations:
The Commonwell is an equal opportunity employer committed to ensuring barrier free employment practices. Should you require workplace accommodation, please let us know, and we will work with you to meet your needs.

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