Claims Specialist - Alternate Dispute Resolution

Description

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Job Responsibilities:

• Under minimal supervision contribute to sustained revenue growth and profitability objectives of the business, handle and proactively manage with a high level of technical expertise disputes that arise from Accident Benefit claims.

• Responsible for the management of Accident Benefit disputes, following established claims settlement and case reserving policies, while ensuring regulatory compliance and coverage interpretation throughout the resolution of the claim. Emphasis is placed on delivering an optimal client experience during the dispute handling of claims while ensuring fair equitable resolutions to all claims.

• Provides Accident Benefit claims technical expertise coaching for colleagues within the unit working closely with the regional and national claims management teams. Emphasis is placed on working in a team environment that supports individual learning and development and the achievement of goals and objectives while creating and maintaining a positive and motivating work environment.

• An additional key responsibility of the successful candidate will involve acting as a Specialist Complex Claims Advisor Accident Benefits, act with a sense of urgency in identifying and meeting client needs. This includes ensuring timely & thorough investigation of claims involving predominantly complex issues and/or high exposures, identifying client eligibility and/or entitlement, and ensuring quick access to all available benefits in order to promote treatment and recovery, and to help the client return to optimal function.

• Responsible for case handling of claims involving predominantly complex issues and/or high exposures including catastrophic injuries; priority of payment, loss transfer and loss reserving.

• Some participation may be required in large loss meetings, mediations, arbitrations and litigations.

• Ensure accurate and timely reserves and take a total cost management approach to claims.

• Record and verify information and documentation from all available sources to ensure a thorough and complete compilation of facts required to resolve the claim; and identify potential coverage issues and/or recovery/liability opportunities.

Additional responsibilities:

• Using established protocols, analyze and evaluate facts of an individual case to assess the benefits available to the client.

• Make good decisions based upon a mixture of analysis, wisdom, experience, and judgement.

• Read and remain current and up to date on case law, legal changes and recent settlements which affect accident benefit claims.

• Apply departmental protocols to ensure efficient, productive and cost-effective results.

• Meet productivity objectives set by the department in terms of pending file count and open/close ratio

Job Requirements:

• Post-secondary education

• Advanced insurance-related designations (CIP/FCIP) would be an asset

• 5-7 years relevant and progressively more responsible Accident Benefit claims work experience, case managing complex Accident Benefit claims with your exceptional technical skills.

• Advanced knowledge of principles and methods pertaining to the resolution of claims

• Knowledge of claims management practices, company operations and policies

• Strong relationship builder

• A proven collaborative approach to problem solving, decision-making and communication with a broad range of audiences

• Effective communication skills including facilitation, consultation, negotiation, and persuasion

• Demonstrated ability to collaborate, coach, counsel and train Advisors

• Strong team player, works well under pressure and ability to deal effectively with change

• Superior organizational and time management skills

• Ability to identify significant business risks/opportunities and controls/enabler

Who We Are:

As part of TD Bank Group, one of Canada's largest financial institutions, at TD Insurance, we care for Canadian families, making it easy to get the best advice, protection, and support in their moments of need, always.

TD Insurance offers a wide range of products, including General Insurance and Life and Health. Everyday, we strive to make every interaction, product and experience remarkably human and refreshingly simple for more than four million customers who count on us.

Our Total Rewards Package
Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial, physical, and mental well-being goals. Total Rewards at TD includes a base salary, variable compensation, and several other key plans such as health and well-being benefits, savings and retirement programs, paid time off, banking benefits and discounts, career development, and reward and recognition programs.

Additional Information:
We’re delighted that you’re considering building a career with TD. Through regular development conversations, training programs, and a competitive benefits plan, we’re committed to providing the support our colleagues need to thrive both at work and at home.

Please be advised that this job opportunity is subject to provincial regulation for employment purposes. It is imperative to acknowledge that each province or territory within the jurisdiction of Canada may have its own set of regulations, requirements.

Colleague Development

If you’re interested in a specific career path or are looking to build certain skills, we want to help you succeed. You’ll have regular career, development, and performance conversations with your manager, as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities.

If you’re passionate about helping clients and building deep, lasting relationships, TD offers diverse career paths where you can grow your expertise and make a meaningful impact.

We're committed to your success and foster a respectful workplace where diverse perspectives are valued, everyone has fair opportunities to grow, and you can unlock your full potential to achieve your career goals. Here at TD, we hire and develop the best.

Training & Onboarding
We will provide training and onboarding sessions to ensure that you’ve got everything you need to succeed in your new role.

Interview Process
We’ll reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call.

Accommodation
Your accessibility is important to us. Please let us know if you’d like accommodations (including accessible meeting rooms, captioning for virtual interviews, etc.) to help us remove barriers so that you can participate throughout the interview process.

We look forward to hearing from you!

Language Requirement (Quebec only):

Sans Objet