Claims Adjuster, Accident Benefits
4 weeks 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 investigate, assess, and resolve accident benefit claims in compliance with the Insurance Act.
- Gather essential claim details through communication with claimants and their representatives.
- Evaluate coverage eligibility and interpret policy wording to address coverage-related inquiries.
- Process various claims, including income replacement, non-earner, and attendant care claims.
- Accurately reserve files after thorough claim assessments.
- Maintain comprehensive electronic records of all claims.
- Authorize payments upon verification of benefits, eligibility, and reserves.
- Determine the most effective strategies for claims management.
- Verify collateral benefits as necessary.
- Address claimant correspondence and accident benefit forms in line 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 required.
Qualifications:
- A university degree, college diploma in a related field, or CIP designation.
- 2-3 years of experience in claims handling.
- Proficient in Microsoft Word and Excel.
- Exhibit professionalism, friendliness, and courtesy in all interactions.
- Ability to thrive in a fast-paced environment while maintaining composure.
- Team-oriented and adaptable to changing circumstances.
- Strong written and verbal communication abilities.
We value potential. If your experience does not align perfectly with the requirements, we encourage you to provide insights into your capabilities through your application and cover letter.
Salary Range: $48,700 - $89,800
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