Claims Adjudicator

1 week ago


Waterloo, Ontario, Canada Equitable Life of Canada Full time

Job Title: Individual Claims Adjudicator

Job Summary:

We are seeking an experienced Claims Adjudicator to join our Individual Claims team at Equitable Life of Canada. As a Claims Adjudicator, you will be responsible for reviewing and analyzing medical information to determine eligibility for benefits, as well as making independent and objective decisions to determine insureds' eligibility for benefits provided.

Key Responsibilities:

  • Gather and review pertinent information to adjudicate and pay all claims
  • Review and analyze medical information for Critical Illness, Death and Disability claims to determine eligibility
  • Balance accounts monthly, quarterly, and yearly
  • Make independent and objective decisions to determine insureds' eligibility for benefits provided
  • Calculate and request all payments from Reinsurance companies for their liability of Claims
  • Interact frequently with Underwriting, Medical Director, Legal and Compliance to resolve complex claim matters
  • Coordinate and participate on Special Projects within the Department and cross-functionally

Requirements:

  • Knowledge of medical terminology and experience in the interpretation of medical information
  • Sound knowledge of insurance contracts acquired through previous insurance industry experience
  • Excellent verbal and written communication skills
  • Working knowledge of Microsoft Suite and advanced Excel skills
  • Strong attention to detail and prioritization skills
  • Bilingualism in written and spoken French is an asset
  • Knowledge of Equitable Life insurance products is also a definite asset

What We Offer:

  • A healthy work-life balance with employee wellness top of mind
  • Annual bonus program, annual vacation allowance, and company-paid benefits program
  • An additional paid volunteer day each year so you can spend time giving back to the community
  • Immediate enrollment in the company's pension program with employer matching
  • Employee resource groups that support an inclusive work environment
  • Tuition support and specialized program assistance
  • An onsite, full-service cafeteria with a variety of daily options
  • Discounts on company products and services, and access to exclusive employee perks
  • Regular EQ Together events focused on company togetherness and collaboration

How to Apply:

  • Provide two professional references (minimum one supervisor and above)

At Equitable Life of Canada, we are committed to providing equal access to employment opportunities across our organization. Please contact our HR team if you would like to receive our job postings in an alternative format or require an accommodation with the application process.


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