Disability Claims Adjudication Specialist

1 week ago


Toronto, Ontario, Canada CIE_101 Beneva Inc. Full time

Are you looking for a challenging role in claims management within a dynamic and growing team at CIE_101 Beneva Inc.?

We are seeking an experienced Disability Claims Adjudication Specialist to join our national insurance company. As a key member of our team, you will be responsible for managing a diverse portfolio of short and long-term disability claims.

The ideal candidate will have a strong background in claims adjudication and excellent analytical skills to review medical documentation, build return-to-work plans, and make informed decisions on claims. You will also possess exceptional communication skills to provide outstanding customer service to claimants and stakeholders.

This is a fantastic opportunity to grow with our company, and we offer a competitive base salary of $75,000 - $85,000 per year, depending on experience. In addition, you will enjoy excellent benefits, including a defined benefit pension plan, flexible group benefits, and generous vacation allowances.

About the Role:

  • Analyze all relevant information to determine our obligations under insurance contracts.
  • Contact agents involved in a file to obtain necessary information and provide them with decisions and action plans.
  • Select and utilize internal and external interventions to optimize claim outcomes.
  • Interact with external agents to ensure they respect objectives and budgets.
  • Provide customer service by answering calls from claimants and stakeholders.
  • Develop and implement interventions to reduce disability durations.
  • Update data in computer systems and make payments when applicable.
  • Participate in meetings with policyholders for critical reviews of files.
  • Recommend measures to improve service and productivity performance.

Requirements:

  • A college or university degree in Administration, Kinesiology, or Health Sciences (an asset).
  • 3-5 years of experience in disability claims adjudication and management within an insurance company.
  • Excellent command of English and French (spoken and written).
  • Strong knowledge of insurance contracts.
  • Able to work independently and collaboratively at all levels.
  • Strong organizational skills.
  • Good analytical, decision-making, and problem-solving skills.
  • Excellent prioritization skills.

Benefits:

  • Competitive base salary ($75,000 - $85,000 per year)
  • Defined benefit pension plan
  • Flexible group benefits
  • Generous vacation allowances


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