Claims Examiner (18 months contract)

Securian Canada • Waterloo, ON

5d • CA$55,000 - CA$65,000 • Hybrid

About The Position

The Claims Examiner will be responsible for evaluating claims and determining benefit eligibility by analyzing contractual terms alongside medical and functional information. You will be required to apply established processes and ensure decisions are aligned with policy requirements. By adhering to internal and external guidelines, you will deliver timely and accurate decisions while maintaining a high standard of service for all stakeholders. The base salary range for this position is between $55,000 to $65,000 depending on experience. Details of our additional benefits are outlined below. This job posting is for an existing vacancy. Only one position is available. However, it may be based in multiple locations: Toronto (ON), or Waterloo (ON), or Montreal (QC). We use artificial intelligence tools in our recruitment process to help with application review and improve the efficiency of our assessments. These tools are used responsibly and do not replace human decision-making, as we continue to manually review all applications.

Requirements

• Post-secondary education preferred or equivalent work experience;
• Fundamental knowledge of Microsoft suite of products;
• Prior claims experience preferred;
• Medical experience obtained through claim assessing, underwriting, nurse/health profession and medical terminology;
• Strong analytical skills combined with a thorough knowledge of insurance practices and principles enabling wise problem-solving;
• Strong attention to details with a dedication to accuracy and high-quality service;
• Stellar interpersonal and communication skills, both written and verbal;
• Ability to professionally manage stressful situations and to deliver difficult news in a tactful and empathetic manner;
• Ability to multitask with complex aspects while respecting different timelines of delivery while focused on positive outcome for all stakeholders;
• Positive attitude contributing to positive morale and team spirit.

Responsibilities

• Responsible for assessing claims for benefit by reviewing contractual, medical, and functional information and in accordance with certificate provisions, adhering to established routines and processes for our various clients;
• Follow up with diligent communications with the different stakeholders, to obtain or provide information regarding claim status and reasoning, and complete reporting as required;
• Thoroughly document the analysis according to Securian’s policies and processes;
• Effectively manage an active caseload in accordance with client service standards and best practice guidelines and established KPI’s and TAT’s;
• Contribute to and foster a positive and dynamic working environment by supporting team members and through collaboration to department project work, and with plan members, plan sponsors and other stakeholders, to ensure service standards are met;
• Learn and apply tools and technology that support continuous improvement by identifying opportunities to improve processes and customer service delivery and adapting to changes as improvements are implemented;
• Perform other related duties, as assigned.

Benefits

• Flexible work arrangements with monthly financial allocations to support your work-life balance;
• Generous starting paid vacation time, plus additional vacation days for every year of service;
• Paid volunteer day so you can dedicate time to a cause you are passionate about;
• Paid personal and wellness days to support your total wellbeing;
• Educational assistance of up to $3,500 a year (with approval from your manager);
• Flexible health and wellness account (in addition to comprehensive drug and dental coverage) to help pay for a wide range of wellbeing services that are meaningful to you;
• Up to 14% of combined contributions to the RRSP matching program;
• Family-friendly maternity/parental leave

What This Job Offers

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