Claims Operations Manager
2 months ago
We are seeking a highly experienced and skilled Claims Manager, Accident Benefits Technical to join our team at Definity. This is a leadership role that requires a strong background in claims handling, management, and leadership.
Key Responsibilities- Manage a team of Claims Technical Advisors responsible for providing direction and oversight of reserve activity and payments on large or complex claims files.
- Liaise with other claims experts on technical and claims issues.
- Actively participate in all Committees.
- Ensure appropriate governance and provide technical direction and set formal practices in place.
- Engage all stakeholders in the effective management of a claim including underwriting, reinsurance, actuary, and senior leadership.
- Conduct quality assurance audits of our Claims staff and vendors.
- Assist in training and providing technical support to team members.
- Support team members through transformation, actively lead through change while maintaining a high-performance work environment.
- Act in a consultative and advisory capacity on claims matters such as coverage, policy interpretation, and settlement negotiation to help resolve claims-related issues.
- Support remediation and knowledge transfer on best practices, processes, and regulatory compliance.
- Effective management of loss costs and expenses through critical evaluation of policies and procedures and execution.
- Provide corporate governance over claims adjudication practices ensuring technical services and operational teams are managing claims in accordance with regulatory requirements, company policies, and procedures.
- Maintain a respectful and productive business relationship with vendors, service providers, legal firms, and internal stakeholders.
- Collaborate, coordinate, and lead projects in conjunction with National AB claims and Claims Operations.
- Monitor key performance indicators monthly to identify trends. Monitor trends and develop strategies and action plans in consultation with the claim's operations.
- Manage oversight initiatives as assigned.
- University degree in any discipline or a 2-year college diploma from a provincially recognized and funded community college or fully completed CIP designation.
- A minimum of 15 years general claims handling experience.
- A minimum of 5 years claims leadership experience.
- A demonstrated history of change management.
- Experience with mediation, arbitration, and litigation.
- Experience coaching and mentoring junior staff.
- Strong interpersonal skills.
- Strong communication skills.
- Proficient in MS Office and strong computer skills.
- A desire to work at the pinnacle of the adjusting experience in a high-performance team.
- Strong industry relationships with colleagues at other carriers, vendors, and brokers.
- Perform well in a busy operation and remain calm under pressure.
- Strive to continually push the boundaries of your adjusting experience and personal learnings.
- 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.
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