Insurance Claims Examiner
7 days 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 benefits payable
- 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 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
Definity is a company that values diversity, equity, and inclusion. We believe that a diverse and inclusive workplace is essential to our success. We are committed to creating a work environment that is welcoming and inclusive for all employees.
We offer a range of benefits to our employees, including a hybrid work schedule, company share ownership program, pension and savings programs, paid volunteer days, and educational resources. We also prioritize wellness and recognition programs, and offer discounts on products and services.
At Definity, we are committed to making insurance better for our customers. We believe that our employees are the key to our success, and we are committed to supporting their growth and development.
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