Claims Specialist Level 1

3 weeks ago

Lindsay, Canada The Commonwell Mutual Insurance Group Full time

The purpose of this position is to review, analyze, evaluate and negotiate minor to moderate claims related to Property, Commercial, Liability and Auto losses including Accident Benefits administration. The incumbent is responsible for investigating these losses where necessary as well as assigning the appropriate independent adjuster and relevant experts to assist in the effective management and resolution of the claim.

**What will you do**:

- Accountable for claims at all transaction levels including, coverage interpretation, evaluation, Reserve adjustments, payments, written and verbal communication, expert requirements, and internal reporting requirements, Requires support for claims with greater complexity
- Consults as required for authority requests with respect to payments and incurred handling
- Reviews claims queries and complaints and takes action, where necessary, receives support, where required in managing complex queries or complaints

**Tools / Technologies**:

- Working knowledge and ability of reading and interpreting all relevant policy wordings including OAP, and most OPCF endorsements
- Working understanding of reserve calculation and exposure
- Working understanding of liability exposure and subrogation opportunities
- Working understanding of vendor network and required coordination in the effective resolution of the claim
- Working knowledge of injury exposure and required reporting processes
- Completion of Post-Secondary Education
- Prior experience in customer service
- Working towards, or completion of CIP designation, and an active pursuer of the necessary education to respond to a changing marketplace
- Great organizational skills and ability to multi-task is required
- Thorough attention to detail is a must to ensure accuracy of claims documents, policy coverage interpretation and recognition of financial exposure
- Ability to perform moderate mathematical calculations is required
- Effective communication skills: verbal, non-verbal 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 problem solving skills and negotiation skills are required for this position
- Strong computer literacy, proficiency in all Microsoft Office programs and Internet navigation

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