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Medical Insurance Claim jobs in Toronto, ON

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    • Review and analyze insurance claims related to GAP and Mechanical Breakdown Insurance policies.
    • Evaluate claim documentation, repair estimates, and policy…
    • 1+ years’ experience in experience in insurance claims handling.
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    • Arranging independent medical examinations, including drafting and preparing the medical briefs.
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    • 2 -10 years’ experience handling bodily injury claims, including both general liability/premises operations claims and auto tort liability.
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    • Obtain approval from Manager on claims above authority.
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    • Establish insurance coverage tailored to client needs.
    • Respond to inquiries and monitor claims with a high level of customer service.
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Nationally Licensed Insurance Claims Adjudicator - GAP Insurance Mechanical Breakdown Insurance
Guarantee VC
·
4.0
220 Duncan Mill Road, North York, ON M3B 3J5
$60,000–$65,000 a year
Permanent, Full-time
Apply now

Job details

$60,000–$65,000 a year
Paid time off, Dental care, Life insurance, Casual dress, On-site parking
Permanent, Full-time
220 Duncan Mill Road, North York, ON M3B 3J5

Full job description

Job Summary

We are seeking a highly skilled and licensed Insurance Claims Adjudicator specializing in GAP Insurance and Mechanical Breakdown Insurance. In this role, you will evaluate, process, and resolve insurance claims related to mechanical breakdowns and GAP coverage, ensuring accurate adjudication while providing exceptional customer service. The ideal candidate will possess strong analysis skills, negotiation abilities, and organizational expertise to manage complex claims efficiently and effectively. This position offers an opportunity to contribute to a dynamic team dedicated to delivering reliable insurance solutions.

Responsibilities

  • Review and analyze insurance claims related to GAP and Mechanical Breakdown Insurance policies.
  • Evaluate claim documentation, repair estimates, and policy coverage details to determine claim validity.
  • Negotiate settlements with policyholders, repair shops, and other stakeholders to reach fair resolutions.
  • Ensure compliance with company policies, industry regulations, and licensing requirements throughout the adjudication process.
  • Maintain detailed records of claim activities, decisions, and correspondence for audit purposes.
  • Collaborate with internal teams to resolve complex or disputed claims promptly.
  • Provide exceptional customer service by communicating clearly and professionally with claimants and stakeholders.
  • Stay updated on industry regulations, policy changes, and best practices relevant to insurance claim adjudication.

Requirements

  • Valid and current insurance licensing as a Claims Adjudicator or similar credential recognized nationally.
  • Proven experience in insurance claims processing, particularly in GAP Insurance or Mechanical Breakdown Insurance.
  • Strong negotiation skills to facilitate fair settlements while managing stakeholder expectations.
  • Excellent customer service skills with the ability to handle sensitive situations professionally.
  • Analytical skills necessary for detailed review of claims documentation and policy coverage.
  • Organizational skills to manage multiple claims efficiently while maintaining accuracy.
  • Ability to work independently and collaboratively within a team environment.
  • Attention to detail and high level of integrity in handling confidential information.

Pay: $60,000.00-$65,000.00 per year

Benefits:

  • Casual dress
  • Dental care
  • Life insurance
  • On-site parking
  • Paid time off

Work Location: In person

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