Claims Advisor Ii

3 weeks ago

Markham, Canada TD Bank Full time

400725BR

Insurance

Markham, ON

February 28, 2023

Company Overview

Department Overview

Manage the client relationship and ensure resolution of a broad range of claims from routine - moderately complex within their area of focus and authority. Leverage appropriate support functions in the investigation and assessment of claims, ensuring timely resolution while mitigating risks and escalation.

**Job Description**:
Reporting to the Team Leader, the primary duty of the Accident Benefits Analyst, is to identify and meet client needs and act with a sense of urgency in ensuring a timely and thorough investigation of the claim in order to identify client eligibility and/or entitlement to available benefits. This includes ensuring the injured client has quick access to all available benefits in order to return to optimal function. This is an entry level AB Analyst position handling predominantly medical files; with exposure to develop personal and technical competencies.
- Under direct supervision promotes treatment and recovery of client; is responsible for effective case handling, priority of payment, loss transfer, and loss reserving for routine telephone claims; specifically non-complex medical files with treatment plans that do not result in the individual requiring time off from work. Progress to disability files.
- Gathers, assembles, record and verified information and documentation from all available sources to endure a thorough and complete compilation of facts required to resolve the claim.
- Using established protocols, analyzes and evaluates the facts of an individual case to assess the benefits available to the client. Interprets reports in order to draw accurate conclusion about proposed treatment and/or repairs and/or recommended actions.
- Considers every case as unique and chooses the appropriate methods to achieve file resolution in order to arrive at a fair and equitable claims settlement
- Meet productivity objectives set by the department in terms of pending file count and open/close ratio
- Read and remain current on case law, legislated regulatory changes and recent settlements, which affect accident benefits claims.
- Role may include supporting other lines of business based on need, including FRC and CAT events

**Requirements**:

- Post-secondary education in health (kinesiology/health sciences) or insurance preferred- CIP courses an asset
- You have been working towards a role in Accident Benefits as part of your development plan
- You possess excellent customer service skills and are dedicated to meeting the expectations of internal and external clients.
- You are able to negotiate win/win outcomes when possible
- You have clear and professional written and verbal communication skills
- You demonstrate good listening skills
- You are able to effectively analyze and identify discrepancies or gaps in data and reports
- You demonstrate excellent investigation skills

Hours

35

Inclusiveness

At TD, we are committed to fostering an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of our customers and communities in which we live and serve. If you require an accommodation for the recruitment/interview process (including alternate formats of materials, or accessible meeting rooms or other accommodation), please let us know and we will work with you to meet your needs.

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