Claims Specialist
6 days ago
**Job purpose**
Main function of this role is overseeing the entire claims process, from initial filing to resolution. This position requires strong organizational, communication and leadership skills.
**Duties and responsibilities**
Team Management:
- Provide training, guidance, and performance evaluations for team members.
- Ensure that claims are processed accurately and within established timeframes.
Claim Processing:
- Oversee the intake and initial review of insurance claims.
- Analyze and assess the validity of claims, ensuring they comply with company policies and industry regulations.
- Collaborate with internal teams, such as underwriting and legal, to gather necessary information for claim resolution.
Customer Service:
- Maintain a high level of customer service by effectively communicating with policyholders, claimants, and other stakeholders.
- Address inquiries and concerns related to claims, providing timely and accurate information.
Documentation and Reporting:
- Maintain detailed records of claim activities, decisions, and communications.
- Generate regular reports on claims processing metrics and performance to senior management.
Compliance and Regulatory Adherence:
- Ensure that all claims processing activities comply with industry regulations and company policies.
- Stay updated on changes in insurance laws and regulations.
Continuous Improvement:
- Identify opportunities for process improvement and efficiency in claims handling.
- Implement best practices and strategies to enhance the claims management process.
**Qualifications**
- Bachelor's degree in a relevant field (e.g., business, finance, or insurance).
- Proven experience in claims management or a related field and RIBO Licensed
- Strong knowledge of insurance policies and industry regulations.
- Excellent leadership skills.
- Effective communication and negotiation abilities.
- Analytical and problem-solving skills.
- Attention to detail and the ability to maintain accurate records.
- Proficiency in using claims management software and tools.
Schedule:
- Monday to Friday
Ability to commute/relocate:
- Markham, ON L3T 7T1: reliably commute or plan to relocate before starting work (preferred)
Licence/Certification:
- RIBO License (preferred)
Work Location: In person
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