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    • Valid AMF license (claims adjuster).
    • Claims Review: Analyze and review liability claims.
    • 10 years of experience in liability claims adjusting.
    • Administrative experience with Life and disability claims advantageous.
    • Claims administration including maintenance of claim files, insuring both accepted and…
    • Understanding of medical billing, coding, and or RCM workflows.
    • Understanding of medical billing, coding, and or RCM workflows (preferred).
    • B. interpreting and applying contract wording, medical documentation, claims policies and procedures, statutory requirements and other guidelines affecting…
    • Provide guidance to managers, supervisors, workers, and other stakeholders regarding occupational claims, functional restrictions, return-to-work considerations…
    • Park Georgia Insurance Agencies is an independent insurance brokerage dedicated to providing comprehensive insurance solutions to individuals, families, and…
    • This is a temporary, medical leave relief position.
    • Submit and manage warranty claims accurately and within required deadlines.
    • Direct experience with reinsurance claims, ceded claims, or legacy reinsurance recoveries.
    • O Complex or litigated claims;
    • Salaried rate: $75 per hour.
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    • Has experience in the medical field, medical transcription, or medical administration (an asset).
    • Enter and review medical billing claims with accuracy and…
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    • Support adjudicators with complex, sensitive, or precedent‑setting claims.
    • Maintain strong relationships with internal partners to ensure alignment on claims…
    • Hunt Down Discrepancies: Track pending claims, troubleshoot rejections, and recover maximum warranty dollars.
    • Keep Score: Maintain orderly records and generate…
    • Régime de retraite (entre 2% et 6% on égale tes cotisations!).
    • Détenir un DEC en assurance, en administration ou dans un domaine connexe.
    • Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims…
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    • Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims…
    • As a Disability Payment Administrator, you will support plan members by maintaining disability benefit records, assisting with government benefit coordination…
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Job Post Details

TPA Examiner – Liability
$50,000–$75,000 a year
Full-time

Job details

$50,000–$75,000 a year
Tuition reimbursement, Paid time off, Vision care, Dental care, Company pension, Casual dress, Extended health care, Work from home
Full-time
Remote

Full job description

TPA Examiner – Liability

The mission of SIAdvisers Consulting & Solutions is to provide its clients with the highest-quality claims management services available in the industry. Recognized as a premier firm, we continue to strengthen our position as a national leader in the field of claims management services. Our commitment to this mission is demonstrated by our ongoing efforts to:

  • Provide superior and consistent products and services through SIA’s network of employees across Canada.
  • Diligently address the needs of our clients.
  • Offer customized services, as required, to meet the individual demands of our clients.
  • Provide fair and competitive pricing for the products and services offered.
  • Establish and maintain partnerships with our clients to foster long-term relationships.
  • Continue to prioritize excellence at all levels of our organization and reinforce our role as a national leader in claims management services.

Responsibilities

  • Claims Analysis: Examine complex insurance claims (residential, commercial, equipment, cargo).
  • Evaluation: Calculate losses and verify compliance with insurance policies.
  • Settlement: Direct independent adjusters in the negotiation of settlements and manage payments.
  • Collaboration: Work with stakeholders to ensure client satisfaction.
  • Reporting: Prepare clear reports and provide recommendations.

Supervision:

  • Mentor and train junior examiners.
  • Analysis and Compliance: Review entries and ensure adherence to standards.
  • File Management: Manage client files from initial intake to final presentation.
  • Consulting: Provide recommendations for process improvements.
  • Claims Review: Analyze and review liability claims.

Investigations:

Direct independent adjusters in their investigations and settlement negotiations; for litigious files, collaborate with legal counsel and participate in settlement conferences.

Relationships and Compliance:

  • Maintain professional relationships and ensure legal compliance.
  • 10 years of experience in liability claims adjusting.
  • Valid AMF license (claims adjuster).
  • Solid experience in claims handling and third-party administration.
  • Proficiency with insurance policies (commercial and personal lines).
  • Ability to formulate recommendations for the Lloyd’s market.
  • Excellent organizational and communication skills.
  • Team-oriented with a strong focus on customer service.
  • Proficiency in Microsoft Office tools.

Compensation:

  • Competitive compensation package
  • Benefits plan (health insurance)
  • Retirement plan
  • Flexible work environment
  • Reimbursement for training expenses

Benefits:

  • Dental insurance
  • Supplementary health insurance
  • Vision insurance
  • Paid time off
  • Retirement plan
  • Work-from-home option
  • Job location: Remote (telework)

Pay: $50,000.00-$75,000.00 per year

Benefits:

  • Casual dress
  • Company pension
  • Dental care
  • Extended health care
  • Paid time off
  • Tuition reimbursement
  • Vision care
  • Work from home

Work Location: Remote

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