Company: CLIC
Department: Group Benefits
Employment Type: Regular Full-Time
Work Model: Hybrid (2 days in office)
Language: Bilingualism in English and French is an asset.
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 Group Benefits team is a leader in our target markets through service excellence and innovative technology and products. Influenced by our co-operative values, our team of experts work collaboratively with clients to deliver solutions that meet their business needs. The Life Claims Assessor role is the first point of contact for field partners, TPA's, employers and beneficiaries for the payment of Life Claims. This position allows claims to be reported and paid on the first point of contact which allows for increased efficiencies and improved client service.
Interpreting/determining contract provisions on all features of a wide range of products for multiple product lines, Group, and Individual to ensure proper claims adjudication
Taking detailed claim reports and statements from insured, field staff, employers, Third Party Administrators (TPA’s) etc., and document files appropriately
Identifying policies involving reinsurance treaties, communicate with reinsurers when necessary (verbal and written), provide appropriate claim documentation and request reinsurance recoveries
Completing new Claim Administration including history searches, file preparation, system coding and complete Claims Settlements including system coding, issuing cheques, preparing settlement/approval letters, tax slips, etc.
Generating follow-up reports and prioritizing activities based on defined criteria
Approving and issuing expense cheques for medical reports, coroner’s reports, police reports and legal expenses
Allocating life claim examiner workflow (e.g. incoming emails, new claims, understanding authorizing limits to allocate claims (Living Benefits and Death claims)
Effectively respond to difficult phone calls from insured, Third Party Administrators, employers, advisors, beneficiaries etc.
You influence change and are committed to continuous improvement, in order to exceed client expectations.
You leverage critical thinking skills to identify problems and proactively propose solutions.
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 an high school diploma or equivalent.
You have or are working towards Associate, Customer Service Designation.
You have two years of previous experience in specific field/industry.
Having a certificate in medical terminology is an asset.
You have an understanding of a variety of systems (i.e. Ingenium, Life Claims Systems, Compass, OnBase, Horizon, LifePages, Outlook, Salesforce etc.)
Training and development opportunities to grow your career.
Flexible work options and paid time off to support your personal and family needs.
A holistic approach to your well-being, with physical and mental health programs and a supportive workplace culture.
Paid volunteer days to give back to your community.
A comprehensive total rewards package, including competitive salary, bonus, pension and benefits.
Expected salary range $50,280 - $83,800
The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.
Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.
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