Accident Benefits Advisor resolving sophisticated claims for Aviva Canada’s insurance customers. Handling coverage interpretation, investigations, legislation, reserves, and settlement negotiations.
About the role
- Accident Benefits Claims Advisor managing client claims with a focus on functional recovery and service excellence at Desjardins. Collaborating with medical and legal stakeholders to ensure compliance and support client well-being.
Responsibilities
- Investigate, evaluate and negotiate accident benefit claims of moderate to high complexity, ensuring compliance with regulatory and contractual obligations, as well as DGIG best practices
- Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims process
- Manage Disability claims with a keen focus on functional recovery and return to work
- Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well-being
- Collaborate effectively with internal and external stakeholders - such as medical professionals, legal representatives, and rehabilitation providers - to support client recovery and claim resolution
- Apply accurate reserving practices and ensure timely issuance of claim payments in accordance with company standards and best practices.
Requirements
- Bachelor's degree in a related field
- A minimum of three years of relevant experience in accident benefits claim handling
- Intermediate experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery and return to work.
- CIP designation or enrolled in the program
- Knowledge of French is required for positions in Quebec
- Advanced proficiency of English due to the nature of the duties or work tools or because the position involves interactions with English-speaking partners, members and/or clients
- Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule)
- Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts and disability management principles
Benefits
- Competitive salary and annual bonus
- 4 weeks of flexible vacation starting in the first year
- Defined benefit pension plan that provides predictable, stable income throughout retirement
- Group insurance including telemedicine
- Reimbursement of health and wellness expenses and telework equipment
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