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:

• 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

Personal Characteristics:

• 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.

Qualifications:

• 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 diplomain related field or the CIP designation
• Excellent verbal and written communication skills.

Salary range is $55,800 - $102,800

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