About the role

Adjudicating Canadian life and living benefits claims for DMI’s disability and absence management solutions. Assessing policy eligibility, communicating decisions, and managing claimant caseloads.

Responsibilities

Manage a caseload of new and ongoing Life and Living Benefit claims while meeting service standards
Interview claimants, beneficiaries, and employers to gather relevant claim information
Process claims in date order according to client service standards
Assess claims for contractual eligibility and determine applicable plan provisions
Investigate claims using medical information and policy resources
Liaise with insurance agencies, doctors, employees, management, lawyers, and other parties
Apply policy provisions and render claim decisions
Communicate proactively with claimants, beneficiaries, executors, legal representatives, and other stakeholders
Draft and deliver written correspondence outlining claim activity and next steps
Calculate and pay approved claims
Maintain confidentiality of records and medical claims information

Minimum 5 years of claims experience in a group insurance environment
Minimum 2 years of experience adjudicating Life and Living Benefit claims, including Critical Illness, Accident and Serious Illness, Life, and Accidental Death and Dismemberment
Post-secondary degree or diploma, or equivalent experience
Familiarity with medical terminology and Life insurance contract language, specifically surrounding Life and Living Benefits products
Strong MS Office skills, with particular strength in Excel reporting
CEBS, CIP, or LOMA designation is an asset
Medical background is an asset
Must work within the company’s core business hours
Ability to maintain confidentiality of client and corporate records and medical claims information