Claims Specialist, Accident Benefits, Level 2
$64,000–$82,000 year
RemoteCanada
Job Summary
Review, analyze, negotiate, and settle moderate to complex claims related to Accident Benefits, including thorough investigation of losses and assignment of independent adjusters and experts. Support technical development of the peer group through training and mentorship of Level 1 Claims and Claims Support staff. Apply expert knowledge of Ontario SABS Regulations, benefit entitlements, reserve calculations, and reinsurance restrictions while interpreting policy wordings, medical terminology, and case law. Maintain strict confidentiality and empathy when dealing with insureds and claimants, ensuring accurate claims document processing and financial exposure recognition. Work remotely with a flexible work policy, offering competitive compensation and opportunities for career development within a collaborative, inclusive environment.
Required Qualifications
- Completion of Post-Secondary Education
- minimum of 3-5 years of insurance experience
- Prior experience in customer service
- Ability to provide technical training and mentorship to Level 1 Claims, and Claims Support staff
- Working towards, or completion of the CIP designation
- active pursuer of the necessary education to respond to a changing marketplace
- Great organizational skills and ability to multitask
- Thorough attention to detail
- Ability to perform moderate mathematical calculations
- Effective communication skills: verbal, non-verbal and written
- Sound morals, ethics, and confidentiality
- Ability to exercise confidentiality and empathy
- Exceptional problem-solving skills
- negotiation skills
- Strong computer literacy including proficiency in all Microsoft Office programs and Internet navigation
- Expert knowledge of Ontario SABS Regulations
- Working knowledge of benefit entitlement as well as priority, loss transfer and WSIB issues
- Working knowledge and ability of reading and interpreting all relevant policy wordings including the OAP, and most OPCF endorsements
- Working comprehension of reserve calculation and exposures
- Working knowledge of reinsurance restrictions of the reinsurance treaty
- Proficient knowledge of other relevant regulations, including the Insurance Act, WSIB and case law/arbitration decisions
- Proficient demonstration of interpretation and understanding of medical terminology and prognosis
Desired Qualifications
- insurance experience, preferably in claims
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