Sector: Special Market Solutions - Claims; Working Environment: Currently telecommuting but will be transitioning to a hybrid model ; Location: Vancouver; Status: Permanent; Start Date: As soon as possible; Language: French and English (Bilingual) is a requirement
Reporting to the Claims Manager, the Claims Specialist will be responsible to handle complex claims. They must be well versed in AD&D, Life, CI, Disability and Health claims.
As a senior member of the Claims team, the Claims Specialist maintains an outstanding business relationship as it relates to claims with our Claimants, key partners TPA/Brokers and other Stakeholders.
Are you someone who is passionate about providing exceptional customer service, have excellent verbal and written communication skills (French/English)? Are you looking for a role where you can work alongside and positively support and encourage the development of yourself and other team members knowledge and skills? If so, this would be the perfect role for you!
In this role you will be responsible for:
Foster a culture of openness and flexibility with TPA’s and brokers while being compliant with Privacy
Develop and maintain positive and effective business relationships with the claimant base, brokers, group policyholders; benefit administrators, reinsurers and Regional offices staff.
Participate in meetings to discuss claims services and practices, and participate in presentations put on by internal teams or external organizations
Adjudicate complex and/or contentious AD&D, Life, Disability, CI claims, including waiver of premium claims. Will handle level one Appeals. Review proposed amendments and updates being considered to claims or policy forms and provide an appropriate opinion and/or comments concerning the acceptability/adequacy of the proposed change; Will review claims with the Medical Consultants.
May be required to appear on behalf of the Company to testify at Examination for Discovery and other legal proceedings during the course of litigation proceedings when claim decisions are contested, therefore, some travelling is required
Assist with some training and support the development of new hires so that they are well prepared to meet both customer needs and business outcomes.
Evaluate and provide feedback on new hire/learner progression, including providing direction on the key competencies that the new hire is performing well and where there have developmental opportunities.
What we are Looking For:
Degree in Health Sciences or Business Administration or equivalent education and experience.
5-10 years claims experience within the Group Benefits or Special Risk insurance industry
Excellent knowledge of group life, health, accident and sickness plans and understanding of Third Party Administrators and Third Party Payors
Strong desire to provide Superior Customer Service and relationship building skills
Possess strong analytical skills with high attention to detail
Ability to remain calm while being pressured to make payments quickly.
Ability to multi-tasking and prioritize work effectively
Have strong coaching, communication, and presentation skills
Proven ability to manage multiple competing projects and deadlines
Excellent computer skills including all Microsoft Suite applications.
Our employees are our best investment and we have much to offer them.
iA Financial Group is the strength of a company with a human side, with its over 8,000 employees. Together, we have earned the trust of our more than four million clients and 25,000 advisors who have chosen us for their insurance, savings, and wealth management.
With over $200 billion in assets and half a billion invested in technological innovation, we’re a key player in the financial services industry in Canada and the United States. The secret to our success? Investing in you, one person at a time. Because, for over 125 years, we have believed that it’s by supporting our employees and surrounding ourselves with the most reputable leaders in the industry, we will continue to innovate.
At iA, we’re invested in you.
Our commitment to Diversity and Inclusion
At iA Financial Group, we support and celebrate diversity. We strive to provide a workplace that is recognized as inclusive for all, regardless of ethnic origin, nationality, language, religious beliefs, gender, sexual orientation, age, marital status, family situation, or physical or mental disability.
Please note that if you need help or assistance to make the recruitment process more accessible for you, please contact us here. Someone from our team will be happy to assist you.