Life and Living Benefits Claims Adjudicator

Job not on LinkedIn

🔥 46 minutes ago

🇨🇦 Canada – Remote

💵 $68k - $75k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 1%

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Disability Management Institute

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2002

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Disability Management Institute is a Canadian B2B service provider that helps employers and employees manage workplace absence, disability and workers’ compensation claims. For over 20 years DMI delivers early intervention, claims management, rehabilitation and rehab-specialty services, health & safety consulting, stay-at-work programs, mental health services, training and appeals/relief-of-cost support to reduce absence duration, control WCB/claim costs, and support safe return-to-work outcomes.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 3 weeks minimum vacation • 26 long weekends a year through the Happy Friday program • Flexible work options including remote and hybrid schedules • Extended health and dental benefits • RRSP matching • Wellness support • Comprehensive mental health resources • Clear career paths • Personalized learning • Leadership committed to investing in employee development • Accommodation during any stage of the hiring process