Investigation and Settlements Professional
3 days ago
Definity Financial Corporation seeks an experienced Claims- Accident Benefits professional to join our team as a Claims Resolution Expert. In this role, you will be responsible for investigating, evaluating, and settling Accident Benefit claims in accordance with the Insurance Act. Your duties will include assessing coverage eligibility, reviewing and applying interpretations of policy wordings to resolve coverage issues, processing income replacement, non-earner, and attendant care claims, and maintaining detailed file records on an electronic claims system. You will also 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, obtain necessary medical information, and respond to assessment recommendations.
To succeed in this role, you should have a strong background in claims handling, preferably with at least 2-3 years of experience. A university degree, college diploma in a related field or the CIP designation is also required. Proficiency in MS Word and Excel is essential for this position. As a key member of our team, you will work collaboratively to resolve claims efficiently and effectively, ensuring timely payment and resolution for our clients.
Key Responsibilities:
- Investigate, evaluate, and settle Accident Benefit claims in accordance with the Insurance Act
- Assess coverage eligibility and review interpretations of policy wordings
- Process income replacement, non-earner, and attendant care 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
- Review and approve treatment plans for claimant rehabilitation
- Arrange insurer examinations to determine benefits eligibility
- Prepare referral packages and obtain necessary medical information
What We Offer:
A competitive salary range of $48,700 - $89,800 and a dynamic work environment that encourages team collaboration and professional growth.
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