Bilingual Claims Examiner I, Creditor Life and Disability

Co-operators • Hamilton, ON

12d • Hybrid

About The Position

The Disability Claims Examiner I completes the final setup of all new creditor claims after the initial claim record is received from client services. This position is responsible for the complete and final processing of auto adjudicated "A" claims, the initial processing of straightforward "B" claims, and a caseload of total & permanent claims. It also provides administrative support functions to the claims department including maintaining the Claims Centre email box, receiving and distributing facsimiles and contacting policyholders to obtain necessary information.

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 national Creditor team aspires to develop and deliver market leading products and solutions to exceed client expectations. We think strategically and collaboratively to create mutually beneficial results and achieve business objectives. We operate with high-integrity, motivated by our desire to do the right thing for our clients and their members.

Requirements

• Completed a post-secondary diploma
• 6 – 12 months customer service experience
• Bilingualism in English and French is required.

Nice To Haves

• Working towards a medical terminology course is an asset.
• Completion of LOMA 280 & 290 or ACS 100 preferred.

Responsibilities

• Completes the final setup of all new creditor claims after the initial claim record is received from client services.
• Completes and finalizes the processing of auto adjudicated "A" claims.
• Initiates the processing of straightforward "B" claims.
• Manages a caseload of total & permanent claims.
• Provides administrative support functions to the claims department.
• Maintains the Claims Centre email box.
• Receives and distributes facsimiles.
• Contacts policyholders to obtain necessary information.
• Determines member’s coverage and necessary claim records for each product for each new claim record.
• Accepts, pays, and closes "A" claims to their recovery date, not exceeding 2 months of benefits, based on system parameters and department guidelines.
• Accepts and pays "B" claims for 1 month prior to transferring the claim to a level I or level II examiner, based on system parameters and departmental guidelines.
• Requests and reviews supplementary medical information for total and permanently disabled claimants.
• Identifies claims for re-assessment by a level II or level III claims examiner where total and permanent disability is in question.
• Receives and distributes incoming faxes and return mail according to department procedures.
• Manages emails received through the Claims Centre email box.
• Contacts the policyholder to obtain information necessary to confirm coverage.

Benefits

• Opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree