- For each new claim record determine the claimant's coverage and the necessary claim records for each product
- Call the claimant to gather the required information necessary to complete the new claim setup
- For auto adjudicated claims, based on system parameters and department guidelines accept, pay and close a claim to its recovery date not exceeding 4 months of benefits
- For straight forward claims, based on system parameters and departmental guidelines accept and pay a claim for 1 month prior to transferring the claim to a Level II or Level III Claims Examiner
- For Life Express claims, based on system parameters, accept, pay and close a claim. For all other Life Claims transfer to a Level II or Level III Claims Examiner
- Request and review supplementary medical information for total and permanently disabled claimants
- Manage emails received through the Claims Centre email box
- Contact the policyholder to obtain information necessary to confirm coverage
- 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.
- 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.
- You have excellent customer service, computer, and organizational skills.
- Strict confidentiality with respect to client's medical history, financial status and other personal information.
- Training and development opportunities to grow your career.
- Paid time off to support your personal and family needs.
- A holistic approach to your well-being, with a supportive workplace culture.
- Paid volunteer days to give back to your community.
- A comprehensive total rewards package, including competitive salary, pension and benefits.
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Bilingual Claims Examiner I, Creditor Life and Disability - Mississauga, Canada - Co-operators
Description
Company: CUMIS Union
Department: Claims
Employment Type: Permanent Full-Time
Work Model: Remote-Based
Language: Bilingualism in English and French is required.
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. This position is responsible for the complete and final processing of auto adjudicated claims, the initial processing of straightforward 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:
How you will succeed:
To join our team:
What you need to know:
What's in it for you?
