Claims Adjudicator

Description:

Job Requirements (Education, Experience, Knowledge, Skills and Proficiencies):

• University degree in any discipline or equivalent work experience.

• 2-3+ years’ experience in adjudicating claims, preferably disability and critical illness.

• Customer service oriented individual with negotiating skills is essential.

• Excellent interpersonal skills with good oral and written communication skills in English for use in dealing with internal and external customers, claimants, brokers, physicians, employees, hospitals, investigators and lawyers.

• Must have a good working knowledge of medical conditions and terminology, as well as 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 and to respond positively to change.

• 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.

• Ability to thrive in a high energy culture.

• Good analytical skills to evaluate conflicting information from various key sources in order to assess risk in making timely and effective decisions with appropriate.

• Proven ability to make decisions and handle pressure.

• Continuous improvement mindset.

• Ability to communicate in Cantonese and Mandarin is an asset.

• You do the right thing – you can effectively communicate client and business impact, both written and verbal; you clearly articulate business needs between technical and non-technical resources as well as present strategy and vision to management.

• You think big – you are a strategic thinker with the ability to think conceptually beyond day-to-day business realities and to effectively consider downstream impacts.

• You get it done together – you have a proven track record of building strong relationships and collaboration.

• You own it – you make it happen, are accountable and you find solutions.

• You obsess about customers – you have a passion for effortless customer service, and you keep that in the forefront of any initiatives you work on.

• You share your humanity – you like being part of a collaborative team and are open to diverse perspectives...and of course, you like to have some fun at work.