Establish and maintain superior customer service to policyholders, agents, marketing centers
Manage ongoing claims by requesting further medical, financial documentation or investigations
Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements
Make decisions on claim benefit eligibility determination and communicate decisions to stakeholders
Document the claim file to ensure an accurate record of events that transpire in the claim handling
Obtain proper file information and review with policy provisions to verify eligibility
Accurately maintain claim records on system to ensure accuracy of reserve calculations

Fully bilingual (French/English)
2-3+ years’ experience in adjudicating claims, preferably disability.
University degree in any discipline or equivalent work experience in the insurance industry is an asset.
Excellent interpersonal skills with good oral and written communication skills
Good working knowledge of medical conditions and terminology
Experience in the interpretation and application of financial documentation and fair claims practices
Ability to respond constructively and decisively in high pressure or emotional situations
Working knowledge of government legislation and legal precedents, the Insurance Act and/or Quebec Civil Code is an asset.
Good working knowledge of the underwriting process.
Good analytical skills to evaluate conflicting information from various key sources to assess risk

health, dental, mental health, vision, short
and long-term disability, life and AD&D insurance coverage
adoption/surrogacy and wellness benefits
employee/family assistance plans
various retirement savings plans including pension
global share ownership plan with employer matching contributions
financial education and counseling resources
generous paid time off program including holidays, vacation, personal, and sick days
full range of statutory leaves of absence

Bilingual Claims Adjudicator

Key skills