Claims Adjuster

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Claims Adjuster / Expert en sinistre

Sous la supervision du Vice-Président Québec, l’expert(e) en sinistres doit fournir un niveau de service élevé et constant en faisant enquête sur les réclamations des assureurs ou des tiers et en négociant le règlement des réclamations d’une manière satisfaisante pour toutes les parties.

PRINCIPALES TÂCHES ET RESPONSABILITÉS
- Gérer les réclamations attribuées tout en respectant les normes de qualité de l’entreprise, notamment en menant des enquêtes approfondies, en déterminant la couverture et la validité des réclamations, en interrogeant et en communiquant avec les assurés, les requérants et les témoins, en inspectant les sites touchés, en élaborant des rapports et en négociant des règlements.
- Maintenir des dossiers exacts en conformité avec les normes et les procédures de l’entreprise, au moyen des systèmes informatiques spécialisés de l’entreprise.
- Gérer de manière précise et efficace la facturation des dossiers attribués, en fonction des échéanciers établis.
- Aider au recouvrement des comptes débiteurs pour les réclamations attribuées.
- Participer aux efforts de marketing locaux de la succursale, assister à des événements professionnels et sociaux, et développer de nouvelles affaires.
- Maintenir une excellente relation de travail avec les clients existants, de manière à développer nos affaires.
- Démontrer un haut niveau de raisonnement et de compétence en mathématiques pour pouvoir calculer et analyser des données et parvenir à une conclusion logique.
- Suivre des cours de formation continue afin d’être au courant des questions et des changements qui touchent le secteur et les lois.

QUALIFICATIONS
- Bilinguisme (français et anglais)
- Études postsecondaires connexes au secteur de l’assurance
- Être titulaire d’un permis auprès de l’AMF ou pouvoir obtenir un permis provisoire
- Compétences reconnues en matière de règlement de sinistres, de négociation et d'analyse
- Excellentes capacités interpersonnelles et de communication

PRIMARY PURPOSE A claims adjuster is charged with the investigation, evaluation and quantification of an insurance claim. The adjuster will determine and provide recommendations with respect to coverage, liability and quantum, within the terms of the policy.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Manages/adjusts assigned claims while meeting company standards and quality, including conducting thorough investigations; determining coverage and validity of claims, interviewing and communicating with insured, claimants and witnesses; inspecting claims sites as required, assigning external vendors as required, recommendations for reserves, preparing reports and negotiating settlements within granted authority. Participate in mediation and arbitrations as required. Work with defense counsel as assigned.
- Maintains accurate records based on company standards and procedures, using company custom computer systems. Will require the ability to work in external client systems.
- Accurately and efficiently manages the billing for assigned files, within specified timelines
- Assists with collection of accounts receivables for assigned claims
- Assists with local marketing of the branch; attends professional and social events and develops new business opportunities.
- Maintains an excellent working relationship with existing clients to further develop business and will participate as required in client file reviews and audits.
- Committed to continuous education to keep up-to-date with all industry and legislative issues and changes and licensing requirements.
- Responsible to ensure reserves, coding and reporting is up to date on claims files assigned.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing
- Bilingual (English/French)
- Claim adjuster license