Claim Examiner (5617)
Job Posting
Claim Examiner
Organization:
Sutton Special Risk
Province:
Ontario
Location:
Toronto
Job Start Date:
04-Apr-2024
Salary:
Description:
BRIEF DESCRIPTION: Reporting to the Manager of Claims, this full-time role is responsible for the adjudication of accident & health claims and related customer service.
RESPONSIBILITIES INCLUDE:
- Manage a portfolio of Medical, Disability and Critical Illness claims including oversight of reporting, notification, evaluation, case reserving, settlement and file closure.
- Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution
- Settlement of claims within designated authority.
- Regular communication with the claimant and the client.
- Manage relationships with, and ensure appropriate handling by, external TPAs, adjusters and counsel.
- Identify process improvements and recommend changes to policies or procedures to improve quality of service and competitiveness.
Requirements:
THE SUCCESSFUL CANDIDATE:
- 5+ years of Accident & Health claims experience. Some commercial P&C experience an asset.
- A college diploma or a university degree is an asset.
- Experience working with Lloyd’s coverholders an asset.
- Have a strong ability to multitask and thrive in a fast-paced environment.
- Are a skilled communicator.
- Bilingual (English/French) preferred.