Company: CUMIS Union
Department: Creditor Claims
Employment Type: Regular Full-Time
Work Model: Hybrid (2 days in office)
Language: Bilingualism in English and French is required.
Additional Information: This/these role(s) is/are currently vacant
The Opportunity:
We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients, and our communities.
Our national Creditor team aspires to develop and deliver market leading products and solutions to exceed client expectations. We think strategically and collaboratively to create mutually beneficial results and achieve business objectives. We operate with high-integrity, motivated by our desire to do the right thing for our clients and their members.
The Disability Claims Examiner I completes the final setup of all new creditor claims after the initial claim record is received from client services. This position is responsible for the complete and final processing of auto adjudicated "A" claims, the initial processing of straightforward "B" claims, and a caseload of total & permanent claims. It also provides administrative support functions to the claims department including maintaining the Claims Centre email box, receiving and distributing facsimiles and contacting policyholders to obtain necessary information.
How you will create impact:
For each new claim record determine the member’s coverage and the necessary claim records for each product.
For A claims, based on system parameters and department guidelines accept, pay and close a claim to its recovery date not exceeding 2 months of benefits.
For B claims, based on system parameters and departmental guidelines accept and pay a claim for 1 month prior to transferring the claim to a level I or level II examiner.
Requesting and reviewing supplementary medical information for total and permanently disabled claimants.
Identifying claims for re-assessment by a level II or level III claims examiner where total and permanently disability is in question.
Receiving and distributing incoming faxes and return mail according to department procedures.
Managing emails received through the Claims Centre email box.
Contacting the policyholder to obtain information necessary to confirm coverage.
How you will succeed:
You adapt to change and are committed to continuous improvement, in order to exceed client expectations.
Your strong communication skills allow you to clearly convey messages.
You’re an effective team player who shares knowledge to support your peers.
To join our team:
You have Completed a post-secondary diploma with 6 – 12 months customer service experience.
You have or are working towards a medical terminology course is an asset.
Completion of LOMA 280 & 290 or ACS 100 preferred.
What you need to know:
Expected salary is $50,143
The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.
Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.
#LI-JL2
Bilingual Claims Examiner I, Creditor Life and Disability • Burlington, ON, CA
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