Claims Examiner Ii, Creditor Life and Disability

1 week ago


Burlington, Canada The CUMIS Group Limited Full time

Company: CUMIS
Department: Claims
Employment Type: Regular Full-Time
Work Model: Remote
Language: This role operates in English.

**The Opportunity**:
We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients, and our communities.

Our national Creditor team aspires to develop and deliver market leading products and solutions to exceed client expectations. We think strategically and collaboratively to create mutually beneficial results and achieve business objectives. We operate with high-integrity, motivated by our desire to do the right thing for our clients and their members.

The Disability Claims Examiner II adjudicates and independently manages a combined caseload of disability claims for straightforward creditor products including Single Premium (SP), Monthly Premium (MP) under $50,000 and Credit Card. This role assesses eligibility for disability benefits, develops case management plans, initiates and implements interventions to minimize claim durations, and calculating, authorizes and issues disability benefits.

**How you will create impact**:

- Request additional information including medical, independent assessments or other professional consultations.
- Interview claimants, employers, loans officers by telephone prior to making claim decisions
- Using the information received, the additional information gathered and the resources available and in accordance with policy provisions determine if the claim is payable.
- Accurately calculate the benefit amount.
- Ensure that timely and appropriate decisions of continued eligibility are made for the assigned caseload of open claims.
- For each claim, develop and execute a proactive case management plan with the objective of minimizing the disability period.
- Clear and comprehensive ongoing written and verbal communication with claimants, employers, loans officers, physicians, treatment providers and internal staff such as client service representatives, filed staff and other parties.
- Actively and accurately present and discuss claim decisions and management plans with senior claims examiners, team leads, manager or other internal resources through the claim referral process.

**How you will succeed**:

- You adapt to change and are committed to continuous improvement, in order to exceed client expectations.
- Your strong communication skills allow you to clearly convey messages.
- You’re an effective team player who shares knowledge to support your peers.

**To join our team**:

- Completion of a post-secondary diploma with 1 year customer service experience, 1 year disability claims management experience preferred.
- Completion of LOMA 280 & 290 required.
- ALHC, ICA C1, degree in a related discipline preferred.
- Knowledge of creditor and insurance products.
- This position engages with primarily anglophone clients located inside and outside of Québec and requires proficiency in English on a regular basis. The essential non-French duties are not assignable to other team members.

**What you need to know**:

- Strict confidentiality with respect to client’s medical history, financial status and other personal information.

**What’s in it for you?**:

- Training and development opportunities to grow your career.
- Flexible work options and paid time off to support your personal and family needs.
- A holistic approach to your well-being, with physical and mental health programs and a supportive workplace culture.
- Paid volunteer days to give back to your community.
- A comprehensive total rewards package, including competitive salary, pension and benefits.



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