Medical Records Transfer, Rsrs jobs in Ontario

TD Insurance is part of TD Bank Group, one of Canada’s largest financial institutions. TD Insurance helps protect clients from the ‘accidents of life’ with a wide range of products including credit protection, life, health, travel, home and auto insurance. With more than three million clients, TD Insurance authorized products and services are available online, over the phone, and through a network of more than 1,000 TD Canada Trust branches.
In Canada, we have two lines of business, General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada.
At TD Insurance, we are committed to fostering an inclusive, accessible environment. With a Canada-wide workforce of over 4,000 employees and offices in Atlantic Canada, Quebec, Ontario and Alberta, our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent is appreciated and professional development is taken seriously. More than just a job, we offer rewarding careers.

Job Description:

Reporting directly to a Team Leader, key responsibility of the Claims Specialist, Accident Benefits, is to act with a sense of urgency in identifying and meeting client needs. This includes ensuring timely & thorough investigation of claims involving predominantly complex issues and/or high exposures, identifying client eligibility and/or entitlement, and ensuring quick access to all available benefits in order to promote treatment and recovery, and to help the client return to optimal function.

• Responsible for case handling of claims involving predominantly complex issues and/or high exposures including catastrophic injuries; priority of payment, loss transfer and loss reserving.

• Some participation may be required in large loss meetings, mediations, arbitrations and litigations.

• Ensure accurate and timely reserves and take a total cost management approach to claims.

• Record and verify information and documentation from all available sources to ensure a thorough and complete compilation of facts required to resolve the claim; and identify potential coverage issues and/or recovery/liability opportunities.

• Using established protocols, analyze and evaluate facts of an individual case to assess the benefits available to the client.

• Make good decisions based upon a mixture of analysis, wisdom, experience, and judgement.

• Read and remain current and up to date on case law, legal changes and recent settlements which affect accident benefit claims.

• Apply departmental protocols to ensure efficient, productive and cost effective results.

• Meet productivity objectives set by the department in terms of pending file count and open/close ratio.

Job Requirements:

• 5 years experience in case managing Accident Benefit claims

• Strong communication skills, listening and responding with authority and compassion.

• Proven ability to communicate effectively and interact successfully with internal and external clients

• Demonstrated leadership skills.

• Strong time-management, demonstrated accuracy and ability to meet deadlines

• Strong analytical skills, recognizing discrepancies and/or gaps in data and reports and use effective questioning techniques

• Strong negotiation skills, focused on win/win outcomes when possible

• Strong written communication, clear and professional letters conveying appropriate type and amount of information

• Effectively interpret the standard auto policy and medical documents and have advanced knowledge of the human anatomy.