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Claims Representative
2 months ago
We are seeking a highly skilled Claims Representative to join our team at Definity. 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 claims
- 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 applicable legislation
- Review and approve 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
- 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
- Hybrid work schedule for most roles
- Company share ownership program
- Pension and savings programs with company-matched RRSP contributions
- Paid volunteer days and company matching on charitable donations
- Educational resources, tuition assistance, and paid time off to study for exams
- Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
- Wellness and recognition programs
- Discounts on products and services
Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions, and the local labour market. In addition to base pay, eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting.
This role requires successful clearance of background checks (including criminal checks and leadership references).
