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Medical Claims jobs in Toronto, ON

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    • Manage challenging coverage claims with tact and professionalism.
    • Obtain approval from Manager on claims above authority.
    • CIP or working towards designation.
    • Prepare medical chronologies and briefs to assist lawyers in understanding the medical issues.
    • 5+ years supporting medical malpractice.
    • Deep technical expertise in underwriting, claims adjudication and contestable investigations.
    • Additionally, 3-5 years experience adjudicating life insurance…
    • Specialized training in disability claims management, dispute resolution or equivalent in actual related experience.
    • Knowledge of medical terminology is a plus.
    • Experience in working with external stakeholders as part of the claims handling process.
    • Previous exposure to pharmacy systems (e.g., Kroll), billing, claims, or medical administration is an asset, but not required.
    • Identify missing medical records and outstanding information required to advance claims.
    • The successful candidate will support our Accident Benefits department…
    • Submit OHIP billing for physicians and conduct monthly reconciliations of claims.
    • Manage direct billing to insurance providers, ensuring accurate and timely…
    • Coordinate medical assessments, expert reports, examinations, and other steps required to advance claims.
    • Negotiate and settle Accident Benefits claims.
    • Motor vehicle accident tort claims;
    • Managing plaintiff personal injury files from beginning to end, including motor vehicle accident tort claims, Accident…
    • Review and approve warranty claims submitted by authorized servicers in accordance with approved warranty guidelines, evaluating repair history, repair cost…
    • You will process claims efficiently, complying with disability legislation policies and collective agreements.
    • Proficiency with Microsoft Office applications and claims management systems.
    • Provide quality customer service by responding to inquiries related to…
  • View similar jobs with this employer
    • We offer a competitive benefits package, which includes but is not limited to medical, dental, and vision.
    • The Product Operations Coordinator will report to the…
    • Provide treatment estimates and manage patient insurance claims or billing.
    • Maintain patient charts and medical records accurately, ensuring patient…
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CAA Insurance Company logo
Intermediate Bodily Injury Adjuster
CAA Insurance Company
(part of CAA Club Group)
·
2.5
60 Commerce Valley Dr E, Thornhill, ON L3T 7P9

Job details

Pay information not provided
Tuition reimbursement, Wellness program
60 Commerce Valley Dr E, Thornhill, ON L3T 7P9

Full job description

About Us


Our P&C Insurance Company offers a dynamic professional environment which strives to offer the ultimate customer experience. We share in each other’s successes, drive change and support each other while cultivating a great working environment to deliver on what is best for the customer.

Who we are


Are you ready to join an award-winning, purpose-driven culture? Welcome to the CAA Club Group of Companies (CCG), where purpose leads to passion!


At CCG, we are committed to delivering an exceptional Associate experience. We offer:
  • Work-life harmony with access to an award-winning holistic wellness program,
  • Continuous learning through our robust corporate curriculum and education reimbursement program,
  • Incredible rewards, travel incentives, and product and service discounts,
  • Pay-for-performance and best-in-class recognition programs, and
  • Competitive benefits that include a defined contribution plan, personal spending account, and so much more.


Join our growing team where everyone belongs!

Position Details

What You Will Do

  • Full handle of both direct deal and litigated files
  • Investigate, evaluate, negotiate automobile and property tort loss of moderate complexity
  • Manage challenging coverage claims with tact and professionalism
  • Arrange and manage vendors for your investigation (IA's, surveillance, defence legal, defence medicals)
  • Accurately assess and reserve the claim in line with Corporate protocols and guidelines
  • Maintain control of expenses through pro-active handling techniques
  • Manage claims in litigation, participate in mediations, pre-trials and trials
  • Obtain approval from Manager on claims above authority


Please note, salary range is not inclusive of total compensation. The expected salary range for this position will be impacted by factors such as the successful candidate’s skills, experience and working location, as well as the specific position’s business line, scope and level. Candidates with salary expectations outside of the range are encouraged to apply.


Who You Are

  • Post-secondary education or equivalent experience
  • CIP or working towards designation
  • Minimum of 3 years experience handling casualty claims required
  • Strong organizational; decision making and problem solving skillset
  • Ability to understand insurance contracts in various jurisdictions
  • Knowledge of principles and practices of claims settlement, policy wording, fraud investigations and coverage issues
  • Ability to cross-reference information with attention to detail
  • Strong general computer knowledge required
  • Excellent communication skills, both written and verbal


Please note that internal applicants are asked to formally express their interest by applying online no later than 10 business days of the position being posted.


Please note that we may use AI tools to help us through the recruitment process.

Our Commitment


We are an equal opportunity employer and are committed to providing employment accommodation in accordance with the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act, 2005 (AODA). CAA CCG will provide accommodations to job applicants with disabilities throughout the recruitment process. If you require an accommodation, please notify us and we will work with you to meet your needs.

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