Individual Claims Adjudicator

Individual Claims Adjudicator

Waterloo, ON, Canada Req #2316 Thursday, July 4, 2024 At Equitable, we realize that your work life is not just about performing a job;

it's about being part of a workplace that helps you grow and reach your full potential. Within our friendly and collaborative work environment, we recognize that the key to our growth and success is a dedicated, motivated and client-responsive staff. Join Equitable today.

Position Title : Individual Claims Adjudicator Reports To : Director, Client and Advisor Care

Department : Individual Claims Term : Permanent Full-Time

Work Arrangements : This is a hybrid role. You will work in our office in Waterloo, ON a minimum of two (2) assigned, consecutive days every other week, plus a fifth (5th) assigned day per month.

You are welcome to work from the office more than the minimum requirement and there may be some roles that are required to work in our office more than the minimum requirement.

The Opportunity : We're looking for an experienced Claims Adjudicator to join our Individual Claims team. Make a difference by applying your knowledge and experience in the adjudication of Life Insurance, Critical Illness, Death and Disability claims.

This is an excellent opportunity to work for one of the Waterloo Area's and Southwestern Ontario's Top Employers for 2024!

What you will be doing :

• Gather and review pertinent information in order to adjudicate and pay all claims
• Review and analyze medical information for Critical Illness, Death and Disability claims in order to determine eligibility
• Balance accounts monthly, quarterly, and yearly.
• Make independent and objective decision to determine insured's / claimants eligibility for benefits provided
• Calculate and request all payments from Reinsurance companies for their liability of Claims
• Interact frequently with Underwriting, Medical Director, Legal and Compliance to resolve complex claim matters.
• Co-ordinate and participate on Special Projects within the Department and cross-functionally

What you will bring :

• Knowledge of medical terminology, and experience in the interpretation of medical information
• Sound knowledge of insurance contracts, acquired through previous insurance industry experience
• Excellent verbal and written communication skills
• Working knowledge of Microsoft Suite and advanced Excel skills
• Strong attention to detail and prioritization skills
• Bilingualism in written and spoken French is an asset
• Knowledge of Equitable insurance products is also a definite asset

What's in it for you :

• A healthy work-life balance with employee wellness top of mind
• Annual bonus program, annual vacation allowance, and company-paid benefits program
• An additional paid volunteer day each year so you can spend time giving back to the community
• Immediate enrollment in the company's pension program with employer matching
• Employee resource groups that support an inclusive work environment
• Tuition support and specialized program assistance
• An onsite, full-service cafeteria with a variety of daily options
• Discounts on company products and services, and access to exclusive employee perks
• Regular EQ Together events focused on company togetherness and collaboration

As part of the recruitment / offer process you will be required to :

Provide two professional references (minimum one supervisor and above)

To learn more about Equitable, we encourage you to explore our organization.