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Reporting to the Team Leader, Accident Benefit Claims, you are accountable for investigating, evaluating and settling Accident Benefit claims
What can you expect in this role?
Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating and settling accident benefit claims in accordance with the Insurance Act
Securing details of claims by corresponding with claimants and / or representatives
Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
Applying applicable Priority Rules chart to each claim file
Processing income replacement, non-earner, and attendant care claims
Reserving files appropriately after assessing claim
Maintaining detailed file records on an electronic claims system
Processing payments after confirming benefits, eligibility and reserves
Coordinating the most effective course of action for claims
Confirming collateral benefits
Responding to claimant correspondence and accident benefit forms in accordance with the applicable legislation
Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation
Arranging insurer examinations to determine benefits eligibility
Preparing referral packages and obtaining the necessary medical information for insurer examinations
Responding to assessment recommendations
Other duties as assigned
What do you bring to the role?
University degree, college diploma in related field or the CIP designation
Minimum 2-3years ofclaims handling experience
Proficient in MS Word and Excel
Professional, friendly and courteous in all interactions, whether with customers or co-workers
Able to perform well in a busy operation and remain calm under pressure