Claims phone adjudicator

Reports to: Manager, Claims
Company: Canadian Premier Life
Location: Toronto Office


Our Toronto Claims Department is seeking a Bilingual Claims Adjudicator to assist in performing support functions and diversified tasks in the day-to-day operations.

  • The Claims Phone Adjudicator would answer incoming customer calls for Life, AD&D, A&H, PTD and Credit policies.
  • Answers incoming customer calls regarding claim status and/or requests for claim forms.
  • Under direct supervision, sets-up claims, including verifying policyholder information, policy effective date, premium status, and verification of claim eligibility. Sends claim form to claimant.
  • Communicates with claimant, verbally and/or in writing, under direct supervision.
  • Under direct supervision, learns the elements of claims handling by on-the-job training about each element of the claims handling process.
  • Maintains compliance with all standards, controls, policies and practices as an active participant in the Company’s Information Privacy and Security Program.
  • Perform other duties as assigned.
  • Post-Secondary Education preferred or equivalent work experience.
  • Must be fluent in both French and English.
  • Possess a thorough knowledge of insurance practices and principles to solve problems.
  • Ability to perform different complex tasks simultaneously within strict time limits.
  • Strong attention to detail.
  • Fundamental knowledge of computers and keyboarding skills.
  • Strong communication skills (strong telephone and interpersonal skills).
  • Knowledge of medical terminology, policy provisions, and provincial regulations.
  • FLHC, FLMI or ALHC designation an asset.
  • Ability to make decisions

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