Casualty Claims Adjuster II

Job Responsibilities
- Investigate automobile bodily injury claims to support prompt, fair resolution
- Make independent decisions, assess risk, think critically, and prioritize effectively
- Review and analyze medical records, police reports, expert reports, and other documentation
- Represent the company in negotiations and settlements with third parties, claimants, and legal counsel
- Manage claims through litigation where required
- Maintain complete, accurate, and timely claim file documentation
- Set, review, and manage loss and expense reserves
- Evaluate settlement criteria and authorize payments according to policy, legislation, authority levels, and best practices
- Communicate professionally and empathetically with customers, brokers, service providers, lawyers, healthcare professionals, and other stakeholders
- Collaborate with Claims Assignment, Collections, Underwriting, Appraisal, Legal, and other internal departments
- Manage a high-volume workload while maintaining quality, accuracy, service standards, and urgency
- Transition to the Care First Team with a health
- and recovery-focused approach
- Assess eligibility and entitlement for accident benefits using policy provisions, legislation, medical information, and evidence
- Review medical information and medical terminology related to injuries, treatment needs, functional limitations, and recovery goals
- Support injured customers through complex situations and help them navigate recovery
- Collaborate with healthcare providers, rehabilitation professionals, employers, legal representatives, and other recovery stakeholders
- Identify opportunities for early intervention and appropriate support
- Develop technical knowledge through training, coaching, feedback, and professional development Requirements
- Minimum of two years of experience handling casualty claims, preferably involving automobile bodily injury
- CIP designation preferred, or demonstrated commitment to pursuing one
- Post-secondary education in a health-related discipline, insurance, business, or related field is an asset
- Experience with medical terminology or in a healthcare, rehabilitation, disability, or medical setting is an asset
- Strong written and verbal communication skills
- Strong investigative, analytical, and critical-thinking skills
- Ability to make well-reasoned, evidence-based decisions using medical, policy, and claim-related information
- Strong negotiation and conflict-resolution skills
- Ability to de-escalate difficult conversations and remain calm and professional in stressful situations
- Strong system navigation skills and ability to use technology efficiently in a high-volume environment
- Growth-oriented attitude and openness to coaching, feedback, continued learning, and changing business processes
- Candidates must be eligible to work in Canada from the anticipated start date and throughout employment Core Competencies Demonstrates expertise in investigating automobile bodily injury claims, managing high-volume workloads, and effectively communicating with various stakeholders. Proficient in analyzing medical records and applying policy provisions to support fair claim resolutions. Highest-signal resume keywords
- Automobile Bodily Injury Claims Handling
- CIP Designation
- Medical Terminology Proficiency
- Negotiation and Conflict Resolution
- Analytical and Critical Thinking Skills Hard Skills
- Claims Management
- Risk Assessment
- Evidence-Based Decision Making
- Settlement Evaluation
- Documentation Management Soft Skills
- Strong Communication Skills
- Empathy
- Problem-Solving
- Stress Management
- Growth-Oriented Attitude Certifications & Qualifications
- CIP Designation Industry Keywords
- Casualty Claims
- Healthcare
- Rehabilitation
- Disability
- Insurance Tools & Technologies
- Claims Assignment Systems
- Technology Proficiency