Claim Examiner

2 weeks ago


Old Toronto, Canada Organization: Sutton Special Risk Full time

Your career opportunity will be visible on the CPBI website for a 60 days period and will be viewed by more than 5000 visitors

Become a CPBI member and save 50$ on your posting

Congratualtions to our most recent Hall of Fame Inductee,
Sherry Lee Gregory

An interview with our Regional Council Member

The CPBI Regional Council of Ontario is pleased to announce its new members for 2024. Congratulations to all of them

BRIEF DESCRIPTION: Reporting to the Manager of Claims, this full-time role is responsible for the adjudication of accident & health claims and related customer service.

RESPONSIBILITIES INCLUDE:

  • Manage a portfolio of Medical, Disability and Critical Illness claims including oversight of reporting, notification, evaluation, case reserving, settlement and file closure.
  • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution
  • Settlement of claims within designated authority.
  • Regular communication with the claimant and the client.
  • Manage relationships with, and ensure appropriate handling by, external TPAs, adjusters and counsel.
  • Identify process improvements and recommend changes to policies or procedures to improve quality of service and competitiveness.
Requirements:

THE SUCCESSFUL CANDIDATE:

  • 5+ years of Accident & Health claims experience. Some commercial P&C experience an asset.
  • A college diploma or a university degree is an asset.
  • Experience working with Lloyd’s coverholders an asset.
  • Have a strong ability to multitask and thrive in a fast-paced environment.
  • Are a skilled communicator.
  • Bilingual (English/French) preferred.
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