Claims Administrator

Career Opportunity

Role Title

Claims Administrator (12-months contract)

Purpose of role

The Claims Administrator is accountable for providing excellent customer service and performing administrative duties for Death and Living benefit claims. They are responsible in initiating claims, accurately answering claims inquiries and provide administration support to our Claimants and Adjudicators.

Job Description

Key Responsibilities
- Answer inbound new and status related claims calls from claimants, members, producers, funeral homes and others. Phone support required and scheduled
- Provide courteous, prompt and accurate service to our claimants making a claim to report death or a living benefits claim
- Proficiently determine the needs of the caller then provide accurate and timely resolution. This includes reviewing and ensuring all necessary requirements are met to avoid delays in the claims process
- Manage the claim notification process: including transacting various systems and maintaining the claims register, sending out claim requirements and regular ongoing follow up for outstanding requirements
- Process administrative transactions and ensure claim is set up accurately for Adjudication review. This requires proficiently understanding various back-office systems and processing necessary transactions for a claim.
- Display high energy, passion and a positive attitude
- Meet tight timelines under pressure while delivering quality service
- Own the results, share work experiences and willingly seek and accept personal accountability
- Continuously learn about customers, their priorities and their expectations
- Take ownership and responsibility for resolving customer concerns with every interaction
- Be flexible, personally embrace change and commit to continuous learning
- Support the organization’s and the Claims Team’s key priorities
- Demonstrate leadership, model customer service values and drive quality and process optimization
- Manages business needs through entry level project and analysis work while assigning a high priority to customer excellence, quality and meeting service level agreements
- Communicate verbal and written information as appropriate to those with a need to know, ensuring information is clear, accurate and compliant with all legal, privacy, confidentiality and company standards
- Perform all required calculations and ensure all activities are in compliance with internal compliance standards
- Assist other team members to ensure that the team meets objectives
- Create ad hoc correspondence and reports for members, producers and external partners
- Receive, verify and match claims benefit cheques to be mailed to claimants
- Meet service level agreements and achieve productivity and quality standards
- Deal with customer complaints defined in company guidelines
- Meet privacy and compliance guidelines.

Key Qualifications
- Education (minimum required): Post secondary diploma in a related field or equivalent experience
- Experience (minimum required): 3-5 years of customer service experience with a passion for service excellence is an asset
- Self-starter with demonstrated ability to prioritize own work and ability to research/problem solve and make decisions both independently and collaboratively within a fast-paced team environment
- Accurate keyboarding skills with good working knowledge of Word and Excel
- Must be proficient in both verbal and written communication to effectively communicate with internal and external customers/partners and vendors
- Understanding of insurance products, services, systems and regulatory requirements, with the ability to recognize discrepancies, anomalies and inconsistencies
- Results-oriented with emphasis on accuracy and attention to detail and the ability to understand and balance both the short and long-term impact of decisions and actions
- Effective multi-tasking and time management skills, including the ability to adapt to changing demands and priorities
- Strong organization skills to effectively monitor and track information with quick ability to learn and leverage new technologies
- Strong reasoning and judgment to balance commitments, financial soundness and quality customer focus
- Creative problem-solving skills to resolve transactions and has an interest in research and problem solving
- Mathematical skills needed for calculation of benefits, taxation and reinsurance
- LOMA 281 and 291 courses an asset
- Post-secondary education preferred and/or related work experience (minimum 1 year work experience)
- Knowledge of French or Spanish is an asset

LI-Hybrid

Hours of Operation
- The role requires flexibility with working hours between 8:00 a.m. and 8:00 p.m., Monday to Friday on a rotational basis
- Flexibility for periodic weekend shifts and statutory holidays may also be required to support changing conditions, customer demand, and business needs.

Equal Opportunity Employment and Inclusion - _at Foresters Financial, we are c