All Lines Claims Adjuster

4 days ago

Waterloo, Canada Ontario Teachers Insurance Plan (OTIP) Full time

Company Description

OTIP (Ontario Teachers Insurance Plan) is a member-focused, service-driven organization. We are committed to putting our people first by fostering a positive and inclusive work environment, providing a competitive total compensation package and investing in career development. Our team is currently looking for an:
**All Lines Claims Adjuster (Hybrid work arrangement)**

**Job Description**:

- Delivers a superior customer experience which includes responding to all general inquires, initiating and maintain contact with insured members, and assists with commodity claims overflow.
- Responsible for confirming coverage for incoming claims by reviewing and compiling facts, obtaining technical reports from various parties as required, investigating questionable claims, reviewing case law to determine liability, completing contractual auto and property coverage analysis and assessing quantum, reviewing subrogation opportunities, negotiating and resolving all-lines of personal insurance claims of minor to moderate nature in a timely manner.
- Coordinates, directs and follows up on work activities performed by outside contractors, experts and service providers to completion.
- Responsible to ensure all correspondence is completed in a time efficient/effective manner including the creation of Critical Path, Proof of Loss, waivers and reservation rights letters.
- Reviews and determines contractual coverage obligations for Statutory accident benefits or Bodily Injury claims by gathering information from insured members, health practitioners, employers, police, claimant’s lawyers, accountants, and other insurers or programs with income continuation plans relating to minor claims.
- Maintains quality service and adheres to organizational standards to deal with all aspects of file handling including reserving, expense and loss control, questionable claims, and creating defined disposition plans for future handling leading to file closure.
- Assists and participates in all dispute forums related to policy coverage and Statutory Accident benefits on behalf of key stakeholders. Provides support and assembles documentation on items in dispute along with resolution recommendations.
- Keeps claims information confidential to protect operations and insured members.
- Responsible for data integrity, issuance of payments to vendors, insureds and experts and to maintain well-organized claim file while ensuring accuracy of data input.
- Adheres to partner's guidelines, contracts, and insurance regulations to ensure legal and regulatory compliance.
- Actively participates in coaching and training sessions and collaborate with team members and management.
- Takes an active role in creating an environment of continuous improvement of work efficiencies and highlight value work.
- Performs other duties within competence, as assigned.

**Qualifications**:

- A post-secondary education and/or college diploma within related field
- CIP designation or working towards designation.
- An All-Lines Adjuster’s license in Ontario and Alberta (Level 1 minimum).
- 2+ years’ experience with a good understanding of both Ontario and Alberta in all-lines claims handling.
- Experience and knowledge in injury claims medical rehabilitation concepts and medical terminology is preferred.
- Excellent communication skills verbal and written to effectively work with internal and external stakeholders.
- Strong time management and organizational skills to manage competing priorities.
- Current Microsoft Office working knowledge
- Ability to learn and adapt in a fast-pace environment including working with various computer programs, databases and software.
- Ability to work independently and as part of collaborative team environment.

Additional Information
**What we offer**:

- Competitive salary and bonus structure
- Industry-leading employer-paid group benefits that start on your first day
- Defined benefit pension plan
- 100% coverage of continuing education and licensing fees (including RIBO and AIC courses)
- Flexible work from home and hybrid options
- Opportunities for advancement
- OTIP and its group of companies strive to create an accessible and inclusive work environment where everyone is treated with respect and dignity. Upon individual request, we will endeavour to remove any barrier to the recruitment and selection processes and provide accommodations for persons with disabilities._
- As a business, we protect what matters most to our members. As an employer, we value what matters most in our workplace. Together, this includes fostering a diverse, equitable and inclusive environment for all. We are committed to learning and evolving so we can continue to celebrate what makes us special. You are who you are, and our differences are what make us unique._

LI-Hybrid

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