We currently have an opening for a Claims Advisors - Accident Benefits in our office. Reporting to the Claims Manager, this role involves the handling of both the Automobile and Accident Benefits portion of the claim, in most cases.
Primary Duties and Responsibilities
- Confirming and explaining coverage is in place and how it applies to reported claims
- Investigating, evaluating, negotiating, and settling total loss claims
- Determining liability
- Explaining the claims process to clients for both automobile and accident benefits
- Obtaining recorded statements
- Collecting and reviewing medical documents and treatment plans
- Obtaining and verifying employment information
- Calculating benefit entitlements
- Authorizing treatment and arranging appropriate billing with clients or providers
- Corresponding with doctors, lawyers, treatment providers, employers, and clients
- Identify questionable claims
- Requesting and arranging MSE's, IME's and IDE's
- Arranging for treatment at specialized facilities
- Documenting activity on the file and issuing payments on a timely basis
- Liaising with Brokers and Underwriters
- Various other duties as required
Required Qualifications
- Minimum of 3+ years of adjusting experience in a similar role (with at least 1 year of Accident Benefits experience would be preferred)
- Post-secondary diploma or degree and / or working towards a CIP / FCIP designation would be considered and asset
- Ability to negotiate and critically analyze data and be decisive
- Familiarity with auto contract and laws applicable to Accident Benefits coverage
- Awareness of medical terminology and medical abbreviations
- Knowledge of common types of traumas, their treatments and recovery periods
- Familiarity with human anatomy and physiology and the psychological consequences of trauma would be helpful in this position
- Posses highly developed interpersonal, organizational and time management skills
- Strong written and verbal communication skills
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