We are currently looking for a Bilingual professional for a Senior Disability Claims Specialist in Toronto. While using your extensive knowledge and expertise in Disability Claims, you will provide high quality, cost effective adjudication services, all while exceeding expectations of the policyholders, agents and customers.
- You will manage a block of claims in accordance with claim guidelines, and in conjunction with the appropriate internal and external consultants and parties, with a focus on the insured’s abilities rather than disabilities.
- You will evaluate medical/financial documents to determine whether disability is substantiated.
- You will maintain an enhanced knowledge of products, procedures, systems and contract wording.
- You will adjudicate claims with minimal supervision or need for consultation, as well as maintain an awareness of specific handling for specific Plan Sponsors and respond to their requests appropriately.
- You will be able to understand and interpret financial documentation, including, personal and corporate tax returns, Notices of Assessment, financial statements, partnership agreements, etc.
- You will demonstrate exemplary decision-making skills even with conflicting/incomplete information to manage conflicts decisively and effectively minimizing cost and exposure to the Company.
- You will provide guidance to less experienced adjudicators, assisting them in resolving complex claim situations, as well as demonstrate leadership in resolving issues at round table discussions.
- You will identify and assist with implementation of continuous improvement solutions of claim processes and procedures
- You will have an opportunity to participate actively in departmental projects utilizing claims technical expertise providing feedback to ensure appropriate best practices are followed.
- You will identify and promote innovative opportunities, using Rehab, Mental Health Specialists and best practices to proactively manage claims.
- You will represent the Company at legal proceedings, if required.
- You will apply the claims vision to all business activities bringing all claims to a success and respectful resolution.
- You are completely Bilingual in English & French
- Disability claims is not new to you. You’ve spent eight years or more growing your knowledge, skills, decision-making and experience in this line of work and you have a clear track record of success.
- You have a thorough understanding of contract interpretation and the ability to articulate decisions with precision.
- You strive to delight customers, their needs and their experience in doing business with us. You put the customer at the centre of everything you do; and you treat our internal stakeholders the same
- You are accountable – you make it happen, you own it and you find solutions
- You are an excellent communicator – you can clearly articulate business needs between technical and non-technical resources as well as present to senior management
- You have an approachable style that makes people want to work with you
- You are resilient, can adapt to change and lead others through change
- You learn fast. You pick up new ideas, concepts, and tools easily
- You have a proven ability to collaborate and negotiate with various stakeholders with competing priorities
- You maintain your composure and best-self during challenging times or challenging interactions