Claims Examiner

1 month ago


Markham, Ontario, Canada Kelly Services , Ltd. Full time
Claims Adjuster Job Description

We are seeking a skilled Claims Adjuster to join our team at Kelly Services, Ltd. in Markham, ON. As a Claims Adjuster, you will be responsible for adjudicating contested and complex claims, approving or denying claims, and interpreting policy provisions.

Key Responsibilities:
  • Adjudicate contested and complex accident, life, critical illness, cancer, and sickness disability claims.
  • Approve, deny, or inquire further for necessary information from claimants, doctors, or hospitals to assess claimant's eligibility for benefits.
  • Interpret and administer policy provisions, including eligibility, definition of total disability, and pre-existing investigations.
  • Review and make decisions for policy rescission, after discussion with underwriting.
  • Refer files for special investigation if required.
Requirements:
  • Minimum high school education or college diploma.
  • Minimum 3 years of claims adjudication experience.
  • Bilingual (Fluent in French and English).
  • Good communication skills, both verbal and written.
  • Mathematical skills - Aptitude for figures.
  • Ability to make good decisions and use sound judgment.
  • Strong knowledge of medical terminology an asset.
  • Knowledge of disability experience an asset.
Perks:
  • Work Monday to Friday, 37.5-hour work week.
  • Hybrid model 3 days in the Markham Office and 2 days remote.
  • In office during training period.
  • $25.00 per hour, plus 4% vacation pay paid weekly.
  • Paid vacation pay and statutory holidays.
  • Hundreds of free training courses through our Kelly Learning Centre that you can access from home 24/7.


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