Claims Technical Consultant, Investigative Services

Co-operators•Edmonton, AB

5d•Hybrid

About The Position

The Technical Claims Consultant, Investigative Services will provide direction and support with respect to technical fraud investigation for Investigative Services. Responsible to contribute to the development of related technical claims training, resources, and communication, as well as monitoring fraud investigation practices through audits and analysis. The Technical Claims Consultant is responsible for the training and to provide technical support and coaching to the Technical Supervisors within Investigative Services. Accountable to work in collaboration with claims peers and leaders to deliver on objectives and client service expectations for their discipline.

Requirements

Seven years of fraud specific experience within the insurance industry.
A post-secondary education.
Fellow Chartered Insurance Professional (FCIP) or Chartered Insurance Professional (CIP) designation, or working towards one.
Advanced knowledge of policy wording, legislation, and regulations.
Ability to use metrics and analytical tools to take action on identified opportunities and trends.
English is required.

Nice To Haves

French is an asset.

Responsibilities

Provide technical consulting and coaching to Technical Supervisors to support sound decision making for claims, litigation management, policy interpretation, policy violations, quantum, assessment, negotiation, and coverage decisions on claims in accordance with legislation and company guidelines.
Participate in learning programs for the discipline as a Subject Matter Expert.
Support with data and trend analysis including monitoring and collaborative action planning established by leadership.
Identify specific trends, legal issues, legislation and convey this information to stakeholders and cross discipline teams.
Assist the leadership team in resolving technical conflicts and client escalations.
Support the execution of operational policies and procedures to ensure compliance with company, government, and legislative standards.
Work collaboratively with stakeholders to implement business processes which enhance client engagement, support profitability, and enrich staff engagement.