Claims Specialist adjudicating Life, Critical Illness, and Disability claims for TD Insurance. Providing professional communication and analysis during claim adjudication processes.
Responsibilities
Ensure claim philosophy for TD Life and Health is administered in a consistent and cost-effective manner in accordance with TPA and vendor agreements
Co-ordinate litigation activity with external counsel and TDBFG legal department
Represent TD Life on litigation claim matters
Support creating, documenting, and implementing training and procedure manuals
Provide leadership, motivate, mentor, and develop staff in all areas of claim adjudication
Approve and decline claims over the Claim Advisors and vendor limits
Provide problem and complaint resolution on contentious claims for issues not resolved by Advisors and vendors
Monitor workflow and reports to ensure all claim service level agreements are met
Conduct Quality Assessment Reviews (QARs) for the vendor and provide feedback and recommendations based on the results
Requirements
Bilingual French and English is required
Minimum Grade 12 education plus 5 years relevant insurance experience in either Individual or Group claims, or University degree or RN qualification
Solid working knowledge of Word and Excel
Solid knowledge of TD Life products
Superior interpersonal skills and ability to handle stressful situations with tact and courtesy
Must be able to contribute to a positive working environment and adapt effectively to a changing environment
Overnight bilingual banking advisor supporting RBC clients through phone, chat, video, and digital channels. Resolving banking concerns and delivering client - focused solutions for Canada’s largest bank.
Bilingual insurance service associate supporting RBC life and health policy clients. Answering calls and emails, explaining policies, and resolving client concerns.
Spécialiste bilingue des conflits au cabinet d’avocats canadien McCarthy Tétrault. Gérant les recherches de conflits, l’ouverture de dossiers, la conformité KYC/AML et les données de facturation.
Spécialiste bilingue des conflits pour McCarthy Tétrault, cabinet d’avocats canadien. Gestion des vérifications de conflits, dossiers clients, conformité KYC/AML et lettres de mandat à Montréal.
Bilingual client relations specialist supporting Transamerica’s Canadian WFG insurance and financial - services field operations. Resolving escalated issues, handling high - volume inquiries, and guiding users across operational systems.
Bilingual Contact Centre Representative supporting TD, a major North American bank, with credit - card and banking inquiries. Resolving issues, recommending products, and delivering compliant customer service in a hybrid role.
Bilingual BDC Representative converting high - volume automotive dealership leads into Sales and Service appointments for Optimy.ai. Using AI tools, CRM platforms, calls, texts, emails, and chat to drive lead conversion.
Bilingual Claims Service Representative handling first - notice - of - loss calls for Allstate Canada’s auto and property insurance customers. Explaining claim processes, gathering information, and coordinating inspections or emergency services remotely.