Accident and Health Claims Adjudicator

2 weeks ago

Toronto, Ontario, Canada Crawford Full time
Description

We are currently recruiting for an Accident and Health Adjudicator to join our team remotely in Ontario. The position location is flexible, and we can offer in-office, hybrid or fully remote working arrangements.

The salary range is $50,000 to $75,000 annually. 

Responsibilities
  • Assess low-complexity Affinity claims (travel, baggage, simple reimbursements).
  • Determine benefit entitlement according to policy and claims handling processes.
  • Collect and analyze additional data (e.g., medical information).
  • Resolve inquiries promptly and maintain client/referral relations.
  • Make timely first contact on new claims and gather additional information to expedite decisions.
  • Prepare verbal and written reports supporting decisions.
  • Record detailed progress notes and prepare correspondence using approved templates.
  • Ensure accurate eligibility determination and adherence to turnaround timelines.
  • Maintain reserves, obtain necessary authority, and process payments promptly.
  • Submit accurate billing and expense reports on time.
  • Provide timely responses to claimants and stakeholders.
  • Document all communications in the system.
  • Deliver clear, professional updates regarding claim status.
Qualifications
  • Experience working in an insurance environment with a good understanding of insurance adjusting. 
  • Accident and Health Adjudication experience would be an asset.
  • Working towards full Independent Adjusting License and CIP Designation.
  • Post Secondary education in an insurance related field considered an asset.
  • Experience in adjusting including the investigation and detailed reporting of multi-line or auto claims.
  • Excellent ability to interact with clients, claimants, and field staff for the exchange of information often requiring analysis.
  • Excellent interpersonal abilities are required to enable effective interaction and communication in both oral and written format with employees, policyholders, employers and other insurance/medical/legal professionals.
  • The ability and willingness to learn multiple computer systems.
  • Strong analytical and decision making skills.
  • Ability to multitask.
  • Ability to effectively manage change.
  • Must be a team player with outstanding customer service skills.
  • Willingness to work in a dynamic environment with opportunity for career growth.

#LI-CD1
#LI-RT1

  • Claims Examiner

    2 days ago

    Toronto, Ontario, Canada AppleOne Employment Services Full time

    Claims ExaminerToronto (Remote)$25-27ph 6 month temp with potential to go permanentOur client is seeking an experienced Claims Examiner to join their growing team.If you have hands-on experience inclaims adjudication, especially within travel or medical insurance, and you're passionate about delivering exceptional customer service, we'd love to hear from...

  • Head of Accident

    2 weeks ago

    Toronto, Ontario, Canada AIG Full time

    At AIG, we are reimagining the way we help customers to manage risk. Join us as theHead of Accident & Health, Canadato play your part in that transformation. It's an opportunity to grow your skills and experience as a valued member of the team.Accident and HealthThe Accident and Health division proudly provides a diversified array of products to their...

  • Head of Accident

    2 weeks ago

    Toronto, Ontario, Canada AIG Full time

    At AIG, we are reimagining the way we help customers to manage risk. Join us as the Head of Accident & Health, Canada to play your part in that transformation. It's an opportunity to grow your skills and experience as a valued member of the team. Accident and HealthThe Accident and Health division proudly provides a diversified array of products to their...

  • Claims Administrator

    2 weeks ago

    Toronto, Ontario, Canada Foresters Financial Full time

    Career OpportunityRole TitleClaims Administrator (6-month contract)Purpose of roleThe 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...

  • Quality & Business Compliance Manager - Accident & Health

    2 weeks ago

    Toronto, Ontario, Canada Description Chubb Full time

    DescriptionChubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad...

  • Workers Compensation Claims Examiner

    2 weeks ago

    Toronto, Ontario, Canada Sedgwick Full time

    By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as...

  • Supervisor, Claims

    1 day ago

    Toronto, Ontario, Canada Toronto Police Service Full time

    Posting Title: Supervisor, ClaimsJob ID #: 7495Salary: $100,338 - $115,868Shift: DaysHours: 35 hoursLocation: Toronto Police CollegeDepartment: WellnessVacancies: 1Job Code: A10SPAOpening Date: Friday December 12, 2025Must Apply By: Friday January 9, 2026Our Mindset ~ Our Connections ~ Our Impact ~ Our DevelopmentService at our Core ~ Do the right thing ~...

  • Claims Associate

    2 weeks ago

    Toronto, Ontario, Canada Burns & Wilcox Full time

    We currently have one exciting new job opportunity in our downtown Toronto office located in the Bay-Adelaide Centre. This junior level claims position is responsible for proactively responding to new claims notices, setting up claim files and assigning claims promptly to examiners, administrative support to the team and assisting with the collection and...

  • Claims Administrator

    2 weeks ago

    Toronto, Ontario, Canada Foresters Financial Full time

    Career OpportunityRole TitleClaims Administrator (6-month contract)Purpose of roleThe 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...

  • Director - Dispute Resolution & Construction Claims

    5 days ago

    Toronto, Ontario, Canada Poly Services Group Full time

    Job DescriptionA leading global consultancy is seeking an experienced and motivated Director to develop and lead its Toronto-based team and drive business growth across Canada, with a focus on the Ontario market. This role involves providing expert consultancy, dispute resolution, and commercial services within the construction and engineering industries....