One of our major Banking clients is looking for a Bilingual Life Insurance Claim Administrator
Length: 12-month contract with a strong possibility of an extension
Location: Toronto, ON – Hybrid_ (2 days in office) _

QUALIFICATIONS:

• Bilingual French & English - write & speak
• Typically, between 2 - 3 years in claims team/ claims administration role, preferably in life insurance
• Knowledge of insurance products, contracts and benefit plans (all individual, disability and group products)
• Financial services experience
• MS Office proficiency
• Verbal & written communication skills - Good.
• Organization skills - Good.
• Collaboration & team skills - Good.
  .
  URGENT: Please read the job description above. If this interests you, apply to the job with your most updated resume, including your contact number and email address.
  The recruiter in charge of this role is Prakash.
  If you do not think you are a match for this opportunity, but know someone who is, feel free to forward this job description to them and you will be eligible for a referral bonus upon a successful hire.
  Please note that this is the most up to date version of job description available at this time – During Client Interview you will receive additional information – variance may apply!

• Administers the initiation and set up of claims for Life, Accidental death & dismemberment, well woman, individual disability insurance, critical illness and group insurance products
• Provides effective & efficient service and delivers the desired experience to policyholders, brokers, agents, claimants by answering incoming calls and managing general questions for a varied range of insurance product
• Provides administration support in setting up new incoming claims, ensuring that all required information is received or requested
• Answers questions (premium payments, eligibility) from policyholders, brokers, third party administrators and claimants related to the Group Insurance Products (LTD, STD, Life Insurance, CI & AD&D)
• Assesses claims based on their individual merit and adjudicates in a fair manner up to designated limit
• Produces reports including time service, Group experience reports and monthly reports for all product lines.
• Collaborates with internal and external stakeholders in order to deliver on business objectives.
• Gathers and formats data into regular and ad-hoc reports, and dashboards.
• Analyzes data and information to provide insights and recommendations. Acknowledges receipt of new claims and request outstanding information for new claims, incomplete claims and approved claims to support processing and monitor ongoing to ensure all information is received.
• Sets up new incoming claims in the appropriate system for reported claims as required based on the client need & product requirements and send out applicable acknowledgement letters.
• Advises POS for Agency claims when a death occurs to stop premium payments. Partners with internal stakeholders in Agency and Direct to initiate new claims set up, monitor workflow to ensure that claims meets servicing turnaround time for adjudication process.
• Manages daily cheques for group claims by printing off cheque run information and distributing it to appropriate internal stakeholders.\
• Scans identified claim files as part of front-end imaging.
• Provides business partners with monthly copy of the expense payment report. Answers incoming calls by policyholders, brokers, agents, beneficiaries and claimants in an efficient and effective manner delivering the desired client experience by assisting with general questions and initiating claims forms for all products.
• Answers administrative questions from Group policyholders, insured’s, brokers, third part administrators and claimants.
• Addresses any claimant or policyholder issue as part of the conversation, escalating as required for any complaint situation
• Follows established policies & procedures
• Participates in quality reviews addressing any issues identified to help reduce risk inherent in claims operations. Follows appropriate guidelines in addressing client concerns and complaints, including documentation of claims to the Complaint’s Ombudsman.
• Completes complex & diverse tasks within given rules/limits
• Analyzes issues and determines next steps. Broader work or accountabilities may be assigned as needed.