Senior Claims Consultant

2 weeks ago

Toronto, Canada SCOR Full time

We are seeking a Senior Claims Consultant to join our team. The role involves close collaboration with our clients, and your focus will be on providing claim reviews and recommendations to clients on claims management strategies. 

You would work locally as part of a global team, collaborating with and learning from claims colleagues in our other markets. The ideal candidate would have a passion for change management and fostering relationships.

The Senior Claims Consultant promotes SCOR Global Life’s image and expertise in a wide variety of Individual and Group life & health insurance products, including life, critical illness and disability. The role involves a wide range of responsibilities including the following:


Claims Adjudication & Relationship Management

Analyze medical, financial and contractual information in order to make timely and accurate decisions on claims Provide value-added claims adjudication expertise on Life, CI, DI, LTD and accidental death claims Provide advice to clients concerning contentious claims, claim practices, policy rescissions and benefit/policy interpretation Establish target response time and ensure that objectives are met  Support other business units with timely communication of issues, escalations or points of interest Remain current on industry practices, emerging trends and developments Participate in the development of Claims management procedures and guidelines within SCOR Global Life Canada Provide advice to underwriting management concerning claims experience in the industry pertaining to underwriting matters, pricing, policy exclusions and insurance applications

Audits & Training

Assist in the performance of claims audits for all lines of business Participate in client meetings and provide training either virtually or in-person; travel to client offices may be required Contribute to the development of training programs for clients

Other:

Review and establishment of claim referral guidelines Provide input into decisions regarding new tools, processes and technology upgrades Project management and data analysis  Respond to special requests from clients and resolve complex issues  Support marketing efforts of the Business Development team by maintaining positive relationships with clients Enhance and maintain internal litigated claim management and record keeping practices to minimize risk exposure, contain costs and realize optimal resolutions Represent the company at industry events as an attendee and/or presenter  Participation on industry committees
10 or more years of insurance/reinsurance claims adjudication experience in Life, CI, and DI In-depth knowledge of life and health insurance industry, products and services Strong decision-making, negotiation and leadership skills Experience in creating training content Claims audit experience Experience with client/industry presentations Exceptional interpersonal and customer service skills Excellent verbal and written communication skills Project management and data analytics experience an asset  Bilingual in French and English

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