- Handling files in good faith and in accordance with legislative requirements
- Handling LAT disputes with and without legal counsel
- Formulating file handling strategies and work plans
- Working with legal counsel
- Conducting settlement analysis
- Participating in Global Mediation and Private Arbitrations
- Providing coaching and support on file handling to Accident Benefit team members.
- Securing details of claims
- Assessing coverage eligibility
- Applying applicable Priority Rules chart to each claim file
- Reserving files appropriately after assessing claim
- Maintaining detailed file records on an electronic claims system
- Processing payments after confirming benefits, eligibility and reserves
- Coordinating the most effective course of action for claims
- Responding to claimant correspondence and Accident Benefit forms in accordance with the applicable legislation
- Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation.
- Arranging insurer examinations to determine benefit eligibility
- Obtaining medical information necessary for insurer examinations
- Responding to assessment recommendations
- Handling complex AB claims including those involving catastrophic injuries
- Other duties as assigned
- Professional, friendly and courteous in all interactions, whether with customers or co-workers.
- Perform well in a busy operation and remain calm under pressure.
- Team player adaptable to a changing environment.
- Strong written and verbal communication skills.
- 5 years of experience handling Accident Benefits claims
- Excellent working knowledge of the Statutory Accident Benefits Schedule.
- Experience coaching others.
- University degree in any discipline or a college diploma in related field or the CIP designation
- Excellent verbal and written communication skills.
- Hybrid work schedule for most roles
- Company share ownership program
- Pension and savings programs, with company-matched RRSP contributions
- Paid volunteer days and company matching on charitable donations
- Educational resources, tuition assistance, and paid time off to study for exams
- Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
- Wellness and recognition programs
- Discounts on products and services
Specialist, Claims- Accident Benefits - Waterloo, Canada - Definity
Description
Job Description
Reporting to the Team Leader, Accident Benefits, you are accountable for handling highly complex, severe and contentious Accident Benefit claims in accordance with the Statutory Accident Benefits Schedule.
Specific Responsibilities:
Personal Characteristics:
Qualifications:
Salary range is $55,800 - $102,800
About Us
Interested in this role, but don't meet every requirement? We encourage you to apply We know from experience that a candidate doesn't need 100% of the qualifications listed to bring incredible value to our team. We're actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren't just "nice to have" — they're essential to our success.
What's in it for you?
Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market. In addition to base pay, eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
Go ahead and expect a lot — you deserve it.
Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting .
Background checks
This role requires successful clearance of background checks (including criminal checks and leadership references).