Claims Adjuster

3 weeks ago

Ontario, Canada Robertson & Company Ltd. Full time

Position: Claims Adjudicator I

Contract Period: 6 months

Location: Remote (Anywhere in Canada)

Hours: Should work EST hours between 9 AM and 5 PM

Pay rate: $19/hr $20.63/hr



Job Summary:


The Claims Adjudicator is accountable for handling claims in accordance with high service standards to meet or surpass client expectations. The Adjudicator is required to make a number of determinations that may affect the member's entitlement to benefits and/or the amount of benefits that are payable. The Adjudicator reviews claims for completeness, enters and assesses claims, and produces the final statement and/or payment responsibility, after the member's insurance benefits are applied to a claim. The Adjudicator will be required to contact various practitioners or service providers to obtain clarification on claim information as necessary.


Key Accountabilities:


Individual Accountabilities:


Claims Adjudication 80%:

• Assesses highly complex health/dental claims in keeping with contract provisions, taking initiative and ensuring that empowered decision making is a key component of the process.

• Assume ownership of the claims assigned with an understanding of the urgency of specific cases and effectively prioritize work accordingly.

• Establish and maintain quality customer service within our turnaround times using influence with internal and external clients to meet all pre-established service standards in order to delight our customers..


Supporting the Business 20 %:

• Sound knowledge and ability to apply appropriate risk management tools and techniques.

• Actively participate in various projects that improve effectiveness and efficiency in claims practices in keeping with our culture of continuous improvement.

• Manage all issues and requirements related to the claim to achieve customer/claim resolution handing off only as appropriate.(claims adjustments, warranty investigation, technical decisions)


Key Shared Accountabilities

• Commitment to Financial Efficiency and Continuous Improvement targets, as required

• Commitment to improving NPS (customer) scores based on overall CX goals

• Commitment to the achievement of the divisional and organizational “Must Win Battles


Job Requirements:

• Post-secondary education or equivalent experience

• Strong customer service focus and the ability to take the initiative

• Previous claims adjudication and/or relevant insurance or health care industry experience a definite asset

• Strong working knowledge of Microsoft Office 365 suite of programs

• Detail oriented with quick assessment skills

• Excellent interpersonal skills and the ability to interact and work with others at all levels to achieve customer resolution


NICE TO HAVE SKILLS


  • Bilingual (English and French)
  • Previous claims experience is an asset.
  • Previous call centre experience is an asset.



We thank you for your interest in the position, however, only those who are qualified will be contacted


Inclusion and Equal Opportunity Employment

Our client is an equal opportunity employer committed to diversity and inclusion; creating an inclusive environment where all team members and clients feel like they belong. We are pleased to consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, Aboriginal/Native American status or any other legally-protected factors. We seek applicants with a wide range of abilities, and we provide an accessible candidate experience; accommodations during the application process are available upon request.

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The Company Our client is an industry-leading claims managment company they are at the forefront of change. Role type: Permanent, Full-time Location: Remote (Ontario & Quebec) Role Summary As a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The Company Our client is an industry-leading claims managment company they are at the forefront of change. Role type: Permanent, Full-time Location: Remote (Ontario & Quebec) Role Summary As a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate...

  • Claims Adjuster

    1 month ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The CompanyOur client is an industry-leading claims managment company they are at the forefront of change.Role type: Permanent, Full-timeLocation: Remote (Ontario & Quebec)Role SummaryAs a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate settlements on...

  • Claims Adjuster

    1 month ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The CompanyOur client is an industry-leading claims managment company they are at the forefront of change.Role type: Permanent, Full-timeLocation: Remote (Ontario & Quebec)Role SummaryAs a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate settlements on...

  • Claims Adjuster

    1 month ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The Company Our client is an industry-leading claims managment company they are at the forefront of change. Role type: Permanent, Full-time Location: Remote (Ontario & Quebec) Role Summary As a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate...

  • Claims Adjuster

    4 weeks ago

    Old Toronto, Ontario, CA DWF Full time

    Responsibilities Field Senior Claims Adjuster – Hybrid Working We are looking for a Senior Claims Adjuster, based at our Toronto office focused on casualty/liability claims. The Claims Adjuster will have responsibility for and progress a caseload of insurance claims to an effective and satisfactory conclusion for clients, ensuring high levels of service...

  • Medical Claims Adjusters

    3 weeks ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The Company Our client is an industry-leading claims managment company they are at the forefront of change. Permanent, Full-time Location: Remote (Ontario & Quebec) As a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate settlements on behalf of...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Kelly Services (Canada), Ltd. Full time

    Kelly has partnered with our client in the Insurance Industry to recruit for a Claims Adjudicator contractor.Job ID Number 13535Job Title: Claims Adjudicator IDates: Sept. 17/24 to Mar. 29/25Hours: Mon – Fri 9am-5pm EST 37.5 hours/weekPay Rate: $20.00/hourLocation: Remote – Open to candidates across Canada but must work EST hoursTypical Day in the...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Kelly Services (Canada), Ltd. Full time

    Kelly has partnered with our client in the Insurance Industry to recruit for a Claims Adjudicator contractor.Job ID Number 13535Job Title: Claims Adjudicator IDates: Sept. 17/24 to Mar. 29/25Hours: Mon – Fri 9am-5pm EST 37.5 hours/weekPay Rate: $20.00/hourLocation: Remote – Open to candidates across Canada but must work EST hoursTypical Day in the...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Kelly Services (Canada), Ltd. Full time

    Kelly has partnered with our client in the Insurance Industry to recruit for a Claims Adjudicator contractor. Job ID Number 13535 Job Title: Claims Adjudicator I Dates : Sept. 17/24 to Mar. 29/25 Hours : Mon – Fri 9am-5pm EST 37.5 hours/week Pay Rate: $20.00/hour Location : Remote – Open to candidates across Canada but must work EST hours Typical Day...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Robertson & Company Ltd. Full time

    Position: Claims Adjudicator I Contract Period: 6 months Location: Remote (Anywhere in Canada) Hours: Should work EST hours between 9 AM and 5 PM Pay rate: $19/hr $20.63/hr Job Summary: The Claims Adjudicator is accountable for handling claims in accordance with high service standards to meet or surpass client expectations. The Adjudicator is required...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada Robertson & Company Ltd. Full time

    Position: Claims Adjudicator I Contract Period: 6 months Location: Remote (Anywhere in Canada) Hours: Should work EST hours between 9 AM and 5 PM Pay rate: $19/hr $20.63/hr Job Summary: The Claims Adjudicator is accountable for handling claims in accordance with high service standards to meet or surpass client expectations. The Adjudicator is required to...

  • Claims Adjuster

    3 weeks ago

    Ontario, Canada, Canada Leap Recruitment Partners Inc. Full time

    About The CompanyOur client is an industry-leading claims managment company they are at the forefront of change.Role type: Permanent, Full-timeLocation: Remote (Ontario & Quebec)Role SummaryAs a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate settlements on...

  • Claims Adjuster

    3 weeks ago

    Mississauga, Ontario, C4W, Peel region, Canada Arthur J. Gallagher Full time

    IntroductionIndulge your passion for problem-solving and embrace the thrill of addressing risk head-on at Gallagher's global brokerage team. Join a family of diverse minds, united by a relentless pursuit of excellence. As part of our team, you'll be the architect of protection, safeguarding businesses and empowering their ambitions. Together,...

  • Liability Claims Adjuster

    3 weeks ago

    Etobicoke, Ontario, Toronto, Canada Monette May & Associates Full time

    Liability Claims AdjusterGreater Toronto AreaMonette May & Associates has been in business since 1998 as a boutique firm of independent insurance adjusters that specializes in the handling of professional liability, errors and omissions, commercial general liability, wrap-up liability and cyber risk claims for insurance companies. The company is licensed to...

  • Office Adjuster

    3 weeks ago

    Ontario, Canada Leap Recruitment Partners Inc. Full time

    About The Company Our client is an industry-leading claims managment company they are at the forefront of change. Permanent, Full-time Location: Remote (Ontario & Quebec) As a Claims Adjuster, you will handle the investigation and evaluation of various personal and commercial insurance claims, assess damages, and negotiate settlements on behalf of...

  • Office Adjuster

    3 weeks ago

    Ontario, Canada Robertson & Company Ltd. Full time

    Position: Claims Adjudicator I Contract Period: 6 months Location: Remote (Anywhere in Canada) The Claims Adjudicator is accountable for handling claims in accordance with high service standards to meet or surpass client expectations. The Adjudicator reviews claims for completeness, enters and assesses claims, and produces the final statement and/or...

  • Property Claims Adjuster

    4 weeks ago

    Burlington, Ontario, A9A, Halton, Canada CUMIS General Insurance Company Full time

    Company: CUMIS Union Department: CUMIS P&C Claims Employment Type: Regular Full-Time Work Model: Hybrid Language: English is required, French is an asset. Job Grade: UN5 Hiring Manager: John Torosantucci Referral Award: No The Opportunity: We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient...

  • Claims Adjuster

    2 weeks ago

    Ontario, Canada Hays Full time

    Your new companyOur client is a Canadian financial services co-operative committed building to a sustainable and resilient society. Their national Property and Casualty (P&C) Claims team aspires to create peace of mind for their clients and communities. Your new roleYou will have a vital role in investigating, negotiating, and resolving complex Accident...

  • Claims Adjuster

    2 weeks ago

    Ontario, Canada Hays Full time

    Your new companyOur client is a Canadian financial services co-operative committed building to a sustainable and resilient society. Their national Property and Casualty (P&C) Claims team aspires to create peace of mind for their clients and communities. Your new roleYou will have a vital role in investigating, negotiating, and resolving complex Accident...