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Insurance Medical Claims Examiner jobs

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    • 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
    • You'll utilize analytical and research skills and medical knowledge to authenticate, adjudicate, and facilitate the payment of claims for Ontario healthcare…
    • Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
    • Prior insurance experience and knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
    • Experience in adjusting single peril auto claims.
    • Document claim files with notes, evaluations and decision making process.
    • Previous claims experience in construction and medical malpractice (MedMal) is considered an asset.
    • Comprehensive, flexible medical and dental benefits.
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    • Enquêter, évaluer et déterminer l’admissibilité au paiement initial et continu des demandes de règlement selon les renseignements médicaux, les exigences de…
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    • Conduct investigations and identify additional information such as medical examinations, customer medical or employment history as required to clarify and/or…
    • Review insurance policy and coverages.
    • Settle claims in accordance with organization’s policies and practices.
    • Valid AMF Claim Adjuster license.
    • Prior insurance experience and/or knowledge in injury claims, medical rehabilitation concepts, and medical terminology is preferred.
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    • 2 -10 years’ experience handling bodily injury claims, including both general liability/premises operations claims and auto tort liability.
    • In this role, you will be responsible for both the oversight and management of third party adjusted claims and direct handled claims.
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    • Detailed knowledge of the property insurance industry and strong solid understanding of property insurance case law.
    • Investigate all types of personal and commercial insurance claims, assess damages and negotiate settlements on behalf of insurance companies or self-insured…
    • Document claim file notes clearly with all communications and activities that occur during of handling the claim using factual and objective information.
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Job Post Details

Claims Examiner - job post

DWF
3.0 out of 5 stars
Toronto, ON
$80,000–$90,000 a year
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Job details

Pay

  • $80,000–$90,000 a year

Location

Toronto, ON

Full job description

Why join us?:
Our Canadian office is currently recruiting for a Claims Examiner. The Claims Examiner will perform customer service and claims functions within all lines of commercial business, but with particular emphasis on General Liability Claims and Professional Liability claims. The incumbent will ensure timely disposition of mid-size to large claims with the purpose of achieving timely resolution / cost effective settlements on behalf of DWF Claims Canada Ltd. and its clients, both international and domestic.
Responsibilities:

  • Review, examine, calculate, investigate, and settle legal expense insurance claims and wrap up liability claims
  • Assess insurance claim coverage, liability, and quantum.
  • Act as a lead client account manager on various Legal expense insurance and liability claims programs
  • Ensure claims are valid and settlements are made according to company practices and client service level agreements.
  • Effectively implement litigation management programs on assigned files
  • Set reserves within authority and make claim recommendations concerning reserve changes to the appropriate client(s), as well as documenting files with clear, well written file notes summarizing activities on each file
  • Provide outstanding customer service and work well with London brokers, insurers, clients, third party claimants and other stakeholders as necessary in the adjustment of claims
  • Assist with the mentorship of junior staff
  • Collaborate with head office personnel out of the United Kingdom.
What will help you succeed in this role?:
  • A bachelor's degree in business, finance, or a related field is required;
  • 3 + years of insurance claims experience or a related role is required;
  • Completion of or pursuing a CIP designation is required;
  • Completion of or pursuing the Ontario Insurance Adjusters License
  • Knowledge of Lloyds of London market is preferred
  • Ability to work independently and assimilate learning materials on many different subjects from various sources;
  • Strong oral and written communication skills as well as listening skills;
  • Committed team player with a preference to work in a collaborative setting;
  • Excellent negotiation skills with an aptitude for diplomacy;
  • This is a hybrid role, however, must be willing to be physically present in the office to monitor phone lines when required

What we offer:

The salary range for this position is $80,000-$90,000 per annum, dependent on years/relevance of individual experience.

We are committed to ensuring that each member of our team feels valued and duly rewarded during their time at DWF.

We are an equal opportunities employer that celebrates diversity and we are committed to creating an inclusive environment for all. We aim to create a positive experience for all candidates and offer any adjustments or additional support needed. If you're excited about the opportunity but your experience doesn’t align perfectly with all the requirements, please apply anyway. You may be the right candidate for the role or others across the wider team.

About us:
DWF is a leading global provider of integrated legal and business services. Our approach delivers efficiency, price certainty and transparency for our clients across the world without compromising on quality or service. Our purpose is to deliver positive outcomes with our colleagues, clients and communities and we foster a culture that places our colleagues at the centre of all that we do.
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