Accident Benefits Claims Examiner

Company Description

OTIP (Ontario Teachers Insurance Plan) is a member-focused, service-driven organization. We are committed to putting our people first by fostering a positive and inclusive work environment, providing a competitive total compensation package and investing in career development. Our team is currently looking for an:
**Accident Benefits Claims Examiner**

**Job Description**:

- Delivers a superior customer experience which includes responding to all general inquires, initiating and maintaining contact with insured members, and assisting with commodity claims overflow.
- Reviews and determines eligibility for Statutory accident benefits by gathering information from insured members, health practitioners, employers, police, claimant’s lawyers, accountants, and other insurers or programs with income continuation plans relating to minor to moderate claims.
- Makes decisions by considering all information and consulting with legal and medical experts when required.
- Maintains quality service and adheres to organizational standards to deal with all aspects of file handling, including reserving, expense and loss control, questionable claims, and creating defined disposition plans for future handling leading to file closure.
- Assists senior AB team members in Arbitration and License Appeals Tribunal proceedings and prepares documentation for case conferences and hearings on behalf of key stakeholders. Provides support and assembles documentation on benefits being disputed along with resolution recommendations.
- Keeps claims information confidential to protect operations and insured members.
- Responsible for data integrity, issuance of payments to vendors, insureds and experts and maintaining well-organized claim files while ensuring accuracy of inputted data.
- Adheres to partner's guidelines, contracts, and insurance regulations to ensure legal and regulatory compliance.
- Actively participates in coaching and training sessions and collaborates with team members and management.
- Takes an active role in creating an environment of continuous improvement of work efficiencies and highlighting value work.

**Qualifications**:

- A post-secondary education and/or college diploma within related field
- CIP designation or working towards designation.
- An All-lines Adjuster’s license in Ontario and Alberta (Level 2 minimum).
- 3+ years’ experience with a good understanding of both Ontario and Alberta in accident benefits.
- 2 years’ experience in all lines claims adjusting.
- Experience and knowledge in injury claims medical rehabilitation concepts and medical terminology is preferred.
- Excellent communication skills verbal and written to effectively work with internal and external stakeholders.
- Strong time management and organizational skills to manage competing priorities.
- Current Microsoft Office working knowledge
- Ability to learn and adapt in a fast-pace environment including working with various computer programs, databases and software.
- Ability to work independently and as part of collaborative team environment
- The ability to communicate in French is asset.

Additional Information
**What we offer**:

- Competitive salary and bonus structure
- Industry-leading employer-paid group benefits that start on your first day
- Defined benefit pension plan
- 100% coverage of continuing education and licensing fees (including RIBO and AIC courses)
- Flexible work from home and hybrid options
- Opportunities for advancement
- OTIP and its group of companies strive to create an accessible and inclusive work environment where everyone is treated with respect and dignity. Upon individual request, we will endeavour to remove any barrier to the recruitment and selection processes and provide accommodations for persons with disabilities._
- As a business, we protect what matters most to our members. As an employer, we value what matters most in our workplace. Together, this includes fostering a diverse, equitable and inclusive environment for all. We are committed to learning and evolving so we can continue to celebrate what makes us special. You are who you are, and our differences are what make us unique._
- #LI-Hybrid_