Life and Living Benefits Claims Adjudicator

Disability Management Institute

. Manage a caseload of new and ongoing Life and Living Benefit claims while meeting service standards .

Posted 10/21/2026full-timeRemote • CanadaMid-LevelSenior💰 CA$68,000 - CA$75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in managing Life and Living Benefit claims, including adjudication and application of policy provisions. Proficient in communication and collaboration with various stakeholders while maintaining confidentiality of sensitive information.

Highest-signal resume keywords

Claims ManagementLife and Living Benefit AdjudicationMedical Terminology FamiliarityMS Office ProficiencyConfidentiality Maintenance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingContractual Eligibility AssessmentClaim InvestigationClaim Decision RenderingClaims Calculation and Payment

Soft Skills

Proactive CommunicationStakeholder LiaisonInterviewing Skills

Tools & Technologies

MS Excel

Certifications & Qualifications

CEBSCIPLOMA

Industry Keywords

Group InsuranceLife InsuranceCritical IllnessAccident and Serious IllnessAccidental Death and Dismemberment

About the role

Key responsibilities & impact

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

What you’ll need

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