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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims adjudication, particularly in disability claims, with strong analytical skills to evaluate risk and make informed decisions. Proficient in customer service and communication, ensuring effective interactions with policyholders and stakeholders.
Highest-signal resume keywords
Claims AdjudicationCustomer Service OrientationBilingual in French and EnglishAdvanced Microsoft Office ProficiencyKnowledge of Insurance Act
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AdjudicationMedical TerminologyFinancial Documentation InterpretationUnderwriting ProcessesAnalytical Skills
Soft Skills
Negotiation SkillsOral CommunicationWritten CommunicationTeam Collaboration
Tools & Technologies
Microsoft Office
Industry Keywords
Disability ClaimsInsurance ActCivil Code of QuébecClaims ManagementPolicy Benefits
About the role
Key responsibilities & impact- Establish and maintain superior customer service for policyholders, agents, and marketing centers
- Manage ongoing claims by requesting medical and financial documentation or investigations as required
- Consult with specialists in all areas
- Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, and endorsements
- Administer policy enhancements, premium waiver, and other policy benefits
- Determine claim benefit eligibility and communicate decisions to stakeholders
- Document claim files to ensure accurate records of events
- Obtain proper file information and review policy provisions to verify eligibility
- Maintain claim records in the system accurately to support reserve calculations
- Communicate with internal and external clients, service providers, brokers, physicians, employees, hospitals, investigators, and lawyers
Requirements
What you’ll need- University degree in any discipline or equivalent experience
- 3+ years of experience in claims adjudication, ideally in disability claims
- Strong customer service orientation with solid negotiation skills
- Advanced proficiency in Microsoft Office (Word, Excel, PowerPoint)
- Fully bilingual in French and English
- Strong oral and written communication skills
- Working knowledge of government legislation and legal precedents; knowledge of the Insurance Act and/or Civil Code of Québec is an asset
- Strong working knowledge of medical conditions and terminology
- Experience interpreting and applying financial documentation and fair claims practices
- Good understanding of underwriting processes
- Strong analytical skills to assess conflicting information, evaluate risk, and make timely, effective decisions
- Ability and willingness to work in a team environment
Benefits
Comp & perks- Incentive programs and incentive compensation tied to business and individual performance
- Health insurance
- Dental insurance
- Mental health benefits
- Vision insurance
- Short- and long-term disability insurance coverage
- Life and AD&D insurance coverage
- Adoption/surrogacy benefits
- Wellness benefits
- Employee/family assistance plans
- Retirement savings plans, including pension
- Global share ownership plan with employer matching contributions
- Financial education and counseling resources
- Paid holidays, vacation, personal, and sick days
- Statutory leaves of absence
- Flexible work environment
- Learning and career growth opportunities
- Inclusion and well-being support
- Reasonable accommodation during the application process