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Sr Representative, Claims- Accident Benefits NEW

Definity Financial Corporation
Mississauga, ON
55 800 $ - 102 800 $ / année
Entry Level

Reporting to the Team Leader, Accident Benefit Claims, you are accountable for investigating, evaluating and settling Accident Benefit claims

What can you expect in this role?

  • Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating and settling accident benefit claims in accordance with the Insurance Act
  • Securing details of claims by corresponding with claimants and/or representatives
  • Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
  • Applying applicable Priority Rules chart to each claim file
  • Processing income replacement, non-earner, and attendant care claims
  • 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
  • Confirming collateral benefits
  • 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 benefits eligibility
  • Preparing referral packages and obtaining the necessary medical information for insurer examinations
  • Responding to assessment recommendations
  • Other duties as assigned

What do you bring to the role?

  • University degree, college diploma in related field or the CIP designation
  • Minimum 4-5years ofclaims handling experience
  • Proficient in MS Word and Excel
  • Professional, friendly and courteous in all interactions, whether with customers or co-workers
  • Able to perform well in a busy operation and remain calm under pressure
  • Team player adaptable to a changing environment
  • Strong written and verbal communication skills

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

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