Int Representative, Accident Benefits Claims

The Opportunity

This role is ideal for a customer-focused claims professional who is passionate about supporting individuals through the accident benefits claims process. Reporting to the Team Leader, Accident Benefit Claims, you will be responsible for investigating and adjudicating claims, determining benefit entitlement, and delivering exceptional service in accordance with the Insurance Act and the organization's Care First principles. The successful candidate will work closely with customers, healthcare practitioners, and other stakeholders to coordinate treatment plans, manage claim files, and ensure timely, fair, and accurate claim resolution.

What to Expect

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating benefits, and administering the principles of Care First in accordance with the Insurance Act
• Securing details of claims by corresponding with customers, care practitioner(s), and/or representatives
• Regular communication with the customer and their health care practitioner(s)
• Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues 
• Applying applicable Priority Rules chart to each claim file
• Processing income replacement benefits
• Reserving files appropriately after assessing claim
• Maintaining detailed file records on an electronic claims system
• Processing payments after confirming benefits, eligibility and reserves
• Coordinating the most effective course of action for claims
• Confirming collateral benefits
• Responding to customer correspondence and forms in accordance with the applicable legislation
• Reviewing Programs of Care treatment plans for customer rehabilitation and other treatments and benefits as appropriate
• Arranging medical assessments as necessary and reviewing and relaying recommendations
• Other duties as assigned

What You Bring

• University degree, college diploma in related field or the CIP designation
• Minimum 2-3 years of claims handling experience
• Proficient in MS Word and Excel
• Professional, friendly and courteous in all interactions, whether with customers or co-workers
• Able to perform well in a busy operation and remain calm under pressure
• Team player adaptable to a changing environment
• Strong written and verbal communication skills

Salary Range: $51,300 - $94,400

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market.

This position is being posted to fill an existing vacancy.

Interested in this role, but don’t meet every requirement? We encourage you to apply! We know from experience that a candidate doesn’t need 100% of the qualifications listed to bring incredible value to our team. We’re actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren’t just “nice to have” — they’re essential to our success. 

What’s in it for you?

• Hybrid work schedule for most roles
• Company share ownership program
• Incentive Program - Eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
• Pension and savings programs, with company-matched RRSP contributions
• Paid volunteer days and company matching on charitable donations
• Educational resources, tuition assistance, and paid time off to study for exams
• Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents 
• Wellness and recognition programs 
• Discounts on products and services

Go ahead and expect a lot — you deserve it.

It’s better here — but don’t take our word for it. Definity was named by Great Place to Work® as one of the Best Workplaces™ in Canada for women, for youth, and for inclusion.

Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting [email protected].

As part of Definity’s commitment to reconciliation, we acknowledge that our work, meetings, and travel take place on the lands now known as Canada, and recognize the enduring presence, wisdom, and stewardship of the First Nations, Métis, and Inuit peoples who have long cared for these lands.

Background checks

This role requires successful clearance of background checks (including criminal checks and leadership references).

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