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Insurance Claims Representative
3 months ago
Position Overview: As a key member of the Accident Benefit Claims team, you will report directly to the Team Leader and play a vital role in the investigation, assessment, and resolution of Accident Benefit claims.
Key Responsibilities:
- Collaborate with the Team Leader to thoroughly investigate and evaluate accident benefit claims in compliance with the Insurance Act.
- Gather essential claim details through effective communication with claimants and their representatives.
- Determine coverage eligibility and interpret policy wording to address coverage-related inquiries.
- Manage claims related to income replacement, non-earner benefits, and attendant care.
- Accurately reserve files based on comprehensive claim assessments.
- Maintain meticulous electronic records within the claims management system.
- Process payments after verifying benefits, eligibility, and reserves.
- Develop and implement the most effective strategies for claims resolution.
- Verify and confirm any collateral benefits.
- Address claimant correspondence and process accident benefit forms in accordance with relevant legislation.
- Review and approve treatment plans for claimant rehabilitation when appropriate.
- Coordinate insurer examinations to assess benefits eligibility.
- Prepare referral packages and secure necessary medical documentation for insurer evaluations.
- Respond to recommendations from assessments.
- Perform additional duties as assigned.
Qualifications:
- A university degree, college diploma in a related field, or CIP designation.
- At least 2-3 years of experience in claims handling.
- Proficient in Microsoft Word and Excel.
- Exhibit professionalism, friendliness, and courtesy in all interactions with clients and colleagues.
- Ability to thrive in a fast-paced environment while maintaining composure under pressure.
- A collaborative team player who can adapt to changing circumstances.
- Strong written and verbal communication abilities.
We value potential and encourage you to share your unique qualifications through your application and cover letter.
Salary Range: $48,700 - $89,800
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