Accident Benefits Claims Advisor Iii
2 weeks ago
**Work Location**:Burlington, Ontario, Canada
**Hours**:35
**Line of Business**:TD Insurance
**Pay Details**:
**Senior Claims Advisor**
**Department overview**:
TD Insurance is part of TD Bank Group, one of Canada’s largest financial institutions. TD Insurance helps protect clients from the ‘accidents of life’ with a wide range of products including credit protection, life, health, travel, home, and auto insurance. With more than three million clients, TD Insurance authorized products and services are available online, over the phone, and through a network of more than 1,000 TD Canada Trust branches.
In Canada, we have two lines of business, General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada.
At TD Insurance, we are committed to fostering an inclusive, accessible environment. With a Canada-wide workforce of over 4,000 employees and offices in Atlantic Canada, Quebec, Ontario and Alberta, our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent is appreciated, and professional development is taken seriously. More than just a job, we offer rewarding careers.
**Job Description**:
Reporting directly to a Team Manager, key responsibility of the Analyst, Accident Benefits, is to act with a sense of urgency in identifying and meeting client needs. This includes ensuring timely & thorough investigation of claims involving predominantly complex issues and/or high exposures, identifying client eligibility and/or entitlement, and ensuring quick access to all available benefits to promote treatment and recovery, and to help the client return to optimal function.
- Responsible for case handling of claims involving more complex issues and/or high exposures including priority of payment, commercial & loss transfer and loss reserving, WSIB, and non-MIG/Non-CAT exposures.
- Ensure accurate and timely reserves and take a total cost management approach to claims.
**Job Requirements**:
- 3+ years handling of Accident Benefits claims involving more complex issues and/or high exposures including priority of payment, commercial & loss transfer and loss reserving, WSIB, and non-MIG/Non-CAT Exposures
- Proven ability to handle complex (Non-MIG, Non-CAT) Exposures
- Effective management of claims with a total incurred over $50,000, files with moderate complexity.
- Strong Negotiations Skills
- Proven ability to resolve customer escalations in a fair and timely manner.
- You have experience in case managing complex Accident Benefit claims with your exceptional technical skills.
- You listen and respond with authority and compassion.
- You are dedicated to and have a proven ability to communicate effectively and interact successfully with internal and external clients.
- You have demonstrated leadership skills.
- You are a proficient time manager.
- You recognize discrepancies and/or gaps in data and reports and use effective questioning techniques.
- You negotiate win/win outcomes when possible.
- You write clear and professional letters conveying appropriate type and amount of information.
- You effectively interpret the standard auto policy, particularly the SABS.
- You effectively interpret medical documents and have advanced knowledge of the human anatomy.
- You have above average knowledge and experience with the MS Word/Excel.
- You understand the need for accuracy and meeting deadlines.
**Additional Information**
- Ability to process and handle confidential information with discretion
- Ability to analyze, organize and prioritize work while meeting multiple deadlines
- Ability to set priorities and complete assignments on time
- Skill in conflict resolution and negotiation skills to collaborate across internal and/or external groups/partners
- Skill in persuading or influencing others
- Skill in negotiation and facilitation
- Skill in negotiating by bringing others together and reaching a consensus
- Skill in managing one's own time and the time of others
- Skill in completing assignments accurately and with attention to detail
- Skill in encouraging and building mutual trust, respect, and cooperation among team members
- Ability to work under pressure and meet required deadlines
- Ability to analyze and prepare documents, reports and correspondence
- Ability to provide guidance and expert advice to management or other groups on technical, systems or process related topics
**Who We Are**
As part of TD Bank Group, one of Canada's largest financial institutions, at TD Insurance, we care for Canadian families, making it easy to get the best advice, protection, and support in their moments of need, always.
TD Insurance offers a wide range of products, including General I
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