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Claims Representative
2 months ago
Job Summary
Definity Financial Corporation is seeking a highly skilled Claims Representative to join our team. As a Claims Representative, you will be responsible for investigating, evaluating, and settling Accident Benefit claims in accordance with the Insurance Act.
Key Responsibilities
- Investigate and evaluate Accident Benefit claims to determine coverage eligibility and resolve coverage issues.
- Correspond with claimants and/or representatives to secure details of claims.
- Assess coverage eligibility and review policy wordings to resolve coverage issues.
- Apply applicable Priority Rules chart to each claim file.
- Process income replacement, non-earner, and attendant care claims.
- Reserve files appropriately after assessing claim.
- Maintain detailed file records on an electronic claims system.
- Process payments after confirming benefits, eligibility, and reserves.
- Coordinate the most effective course of action for claims.
- Confirm collateral benefits.
- Respond to claimant correspondence and accident benefit forms in accordance with the applicable legislation.
- Review and approve, when appropriate, treatment plans for claimant rehabilitation.
- Arrange insurer examinations to determine benefits eligibility.
- Prepare referral packages and obtain necessary medical information for insurer examinations.
- Respond to assessment recommendations.
- Perform other duties as assigned.
Requirements
- University degree, college diploma in a related field, or the CIP designation.
- Minimum 4-5 years of claims handling experience.
- Proficient in MS Word and Excel.
- Professional, friendly, and courteous in all interactions.
- Able to perform well in a busy operation and remain calm under pressure.
- Team player adaptable to a changing environment.
- Strong written and verbal communication skills.
What We Offer
Definity Financial Corporation offers a competitive salary range of $55,800 - $102,800.
