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About the role
- Catastrophic Claims Advisor guiding Ontario clients through complex accident benefits claims at Desjardins. Coordinating recovery, legal, medical, and rehabilitation stakeholders while negotiating fair claim resolutions.
Responsibilities
- Investigate, evaluate, and negotiate high-complexity accident benefit claims while ensuring compliance with regulatory and contractual obligations and DGIG best practices
- Maintain clear and timely communication with clients, provide claim-status updates, address inquiries, and guide clients through the claims process
- Manage catastrophic claims with a focus on functional recovery
- Identify and resolve complex or sensitive issues to achieve fair outcomes and support client well-being
- Conduct settlement discussions and negotiate resolutions where appropriate
- Collaborate with internal and external legal counsel on LAT disputes, reconsiderations, judicial reviews, mediations, and hearings
- Collaborate with medical professionals, legal representatives, rehabilitation providers, and other stakeholders to support client recovery and claim resolution
- Apply accurate reserving practices and ensure timely issuance of claim payments according to company standards and best practices
Requirements
- Bachelor's degree in a related field
- A minimum of five years of relevant experience in accident benefits claim handling
- Other combinations of qualifications and relevant experience may be considered
- Advanced experience managing medical and disability files within the constraints of the Statutory Accident Benefits Schedule with a focus on functional recovery
- CIP designation or enrolled in the program
- Advanced proficiency of English
- Advanced knowledge of regulatory and contractual obligations, including the 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
- Workplace accommodations at any stage in the recruitment process, based on eligibility criteria
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