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    • Reporting to the Manager, Claims Adjudication, the Claims Adjudicator is responsible for processing paper, photo eClaims and pre-determinations for members and…
    • Adhere to partner's guidelines, contracts, and insurance regulations to ensure legal and regulatory compliance.
    • CIP designation or working towards designation.
    • Assess insurance claim coverage, liability, and quantum.
    • 3 + years of insurance claims experience or a related role is required;
    • View all DWF jobs - Toronto jobs
    • Salary Search: Claims Examiner salaries in Toronto, ON
    • Interpret insurance policy wording, determine policy coverages and set reserves on Accident Benefit claims assigned.
    • Ensure files are thoroughly documented.
    • Interpret insurance policy wording, determine policy coverages and set reserves on Accident Benefit claims assigned.
    • Ensure files are thoroughly documented.
    • Detailed knowledge of the property insurance industry.
    • Strong solid understanding of property insurance case law.
    • Provide outstanding service to our customers.
    • In this role, you will deliver top quality claim service and anticipate client needs by building strong and authentic relationships.
    • An uplift of 5% is applied after the probationary period for qualified professional level French bilingualism (both spoken and written).
    • Actuaries typically work behind the scenes to make processes run smoothly and deliver insights as inputs to other processes.
    • Knowledge of Python and SQL.
  • View similar jobs with this employer
    • Detailed knowledge of the property insurance industry and strong solid understanding of property insurance case law.
    • Extensive knowledge of Financial Lines insurance products, claims handling best practices and the investigation and litigation processes.
    • Process dental/health claims and predeterminations accurately in a timely manner within established service standards.
    • Demonstrate high attention to detail.
    • 3 to 5 years of experience adjusting or examining claims within the property and casualty insurance industry.
    • Working Business Language: Bilingual in French and…
    • Minimum seven years of property and casualty insurance experience or business analysis.
    • In addition to salary, full-time and part-time permanent employees are…
    • Utilizing a ‘desktop’ model, IPG examiners manage claims from start to finish.
    • This position is available anywhere in Canada and you must have your independent…
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Job Post Details

Claims Adjudicator - Remote - job post

ClaimSecure
2.3 out of 5 stars
Greater Sudbury, ON P3E 5R2•Hybrid work
From $37,732.50 a year - Permanent, Full-time

Job details

Pay

  • From $37,732.50 a year

Job type

  • Permanent
  • Full-time

Location

Greater Sudbury, ON P3E 5R2•Hybrid work

Benefits

Pulled from the full job description

  • Paid time off
  • Vision care
  • Dental care
  • Life insurance
  • Employee assistance program
  • Disability insurance
  • RRSP match

Full job description

Reporting to the Manager, Claims Adjudication, the Claims Adjudicator is responsible for processing paper, photo eClaims and pre-determinations for members and providers within corporately established turnaround times and accuracy rates.

Principal Responsibilities:

  • Process paper, photo, auditable eClaims and pre-determinations for members and providers daily
  • Maintain an acceptable daily claims count to ensure turnaround times are met
  • Ensure all policies and procedures are followed to ensure accuracy rates are met
  • Perform other duties as assigned to support ClaimSecure

Knowledge, skills and experience:

  • Grade 12 diploma
  • Two years’ experience in data entry
  • Excellent verbal and written communication skills
  • Proven data entry skills
  • Attention to detail

Pay: From $37,732.50 per year

Benefits:

  • Dental care
  • Disability insurance
  • Employee assistance program
  • Extended health care
  • Flexible schedule
  • Life insurance
  • Paid time off
  • RRSP match
  • Vision care
  • Wellness program
  • Work from home

Experience:

  • Data entry: 1 year (preferred)

Work Location: Hybrid remote in Greater Sudbury, ON P3E 5R2

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