Claims Adjuster handling the investigation and evaluation of insurance claims for Sedgwick. Ensuring accurate coverage and validity while maintaining company standards for quality and service.
About the role
- Accident Benefits Claims Specialist handling complex claims for Intact in Canada. Investigating, evaluating, negotiating, and resolving Accident Benefits claims in alignment with corporate policies.
Responsibilities
- Deliver high-quality service while investigating, evaluating, negotiating, and resolving complex Accident Benefits claims in compliance with corporate policies, provincial legislation, and regulatory standards
- Investigate and manage complex Accident Benefits claims arising from automobile losses
- Assess entitlement, exposure, and reserving requirements in alignment with Alberta legislation and company guidelines
- Manage claims with out-of-province exposures, coordinating benefits appropriately across jurisdictions
- Communicate with claimants, legal counsel, medical professionals, rehabilitation providers, vendors, and internal stakeholders throughout the claim lifecycle
- Review and analyze medical records, treatment plans, assessments, and financial documentation to support claim decisions
- Negotiate fair and timely settlements, resolving claims within delegated authority
- Coordinate independent medical examinations (IMEs), rehabilitation services, and vendor support as required
- Maintain accurate, timely file documentation, including reserves, file strategy, and activity notes
- Contribute to process improvements and support operational change initiatives related to Care-First reforms
- Provide technical guidance, coaching, training, and mentorship to junior colleagues and team members
- Partner effectively with internal teams (e.g., Legal, Underwriting, and other departments) to support sound claim outcomes
- Deliver exceptional customer service while navigating sensitive and complex situations with professionalism and empathy
Requirements
- 5-7+ years of insurance experience, including Accident Benefits claims handling within the P&C insurance industry
- Strong technical knowledge of Accident Benefits claims practices, including investigation, evaluation, negotiation, and resolution
- Experience managing complex and litigated Accident Benefits claims
- Working knowledge of out-of-province claims handling and inter-jurisdictional coordination
- Solid understanding of Alberta auto insurance legislation and evolving reforms, including preparedness for the Care-First model
- Excellent negotiation, analytical, and decision-making skills
- Strong written and verbal communication skills, with the ability to manage difficult conversations confidently and professionally
- Proven ability to prioritize and manage a high-volume caseload in a fast-paced environment
- Proficiency with claims management systems and Microsoft Office
- CIP designation (or actively working toward completion) is an asset
Benefits
- Flexible work arrangements and a hybrid work model
- Possibility to purchase up to 5 extra days off per year
- Multiple benefits offered to support physical and mental wellbeing, including telemedicine, Wellness account and much more
- Share plan & other savings: up to 12% of salary or even more
- Annual bonus target, based on the base salary, with a potential payout of up to double the target: 12%
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