Bilingual Claims Adjudicator

Manulife•CAN, Ontario - Full Time Remote, ON

4d•CA$43,875 - CA$73,125•Remote

About The Position

We are currently seeking a Bilingual Disability Claims Adjudicator for a client base across Canada. Product lines include Personal Accident Disability and Financial Institutions. The successful candidate must be able/willing to work in a team environment and be motivated to maintain exemplary customer service to our clients. The role being advertised is an existing vacancy.

Requirements

Fully bilingual (French/English): The successful candidate will be required to communicate in English and French in order to support clients from various jurisdictions outside of Quebec.
2-3+ years’ experience in adjudicating claims, preferably disability.

Nice To Haves

University degree in any discipline or equivalent work experience in the insurance industry is an asset.
Customer service oriented individual.
Excellent interpersonal skills with good oral and written communication skills 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 to assess risk in making timely and effective decisions with appropriate.
Proven ability to make decisions and handle pressure.
Continuous improvement mindset.
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.

Responsibilities

Establish and maintain superior customer service to policyholders, agents, marketing centers
Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.
Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements; administer policy enhancements, premium waiver and other policy benefits
Make decisions on claim benefit eligibility determination and communication 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

Benefits

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 and a global share ownership plan with employer matching contributions)
financial education and counseling resources
generous paid time off program in Canada includes holidays, vacation, personal, and sick days
full range of statutory leaves of absence