[Hiring] Life and Living Benefits Claims Adjudicator @Disability Management Institute

Role Description

The Life and Living Benefits Claims Adjudicator will adjudicate Critical Illness, Accident and Serious Illness, Life, and Accidental Death and Dismemberment claims within established timeframes and within the scope of the policy, while ensuring excellent customer service. The Life and Living Benefits Claims Adjudicator will manage a caseload of new and ongoing claims, apply the appropriate policy provisions to render decisions, and keep claimants, beneficiaries, executors, and other stakeholders informed at every stage of the claim.

This is a remote role within Canada. We are open to candidates across the country, however you must work within our core business hours.

What You’ll Be Doing

• Manage a caseload of new and ongoing Life and Living Benefit claims, ensuring service standards are met
• Interview claimants, beneficiaries, and employers to gather relevant claim information
• Process all claims in date order, in accordance with the agreed upon service standards for each client
• Assess claims for contractual eligibility, determine which plan provisions apply, and investigate accordingly
• Use available resources to assess medical information and policy, liaising professionally with insurance agencies, doctors, employees, management, lawyers, and other parties as needed
• Apply the appropriate policy provisions when reviewing claims and render a decision
• Provide proactive communication to claimants, beneficiaries, executors, legal representatives, and other stakeholders on claim status and progression
• Draft and deliver written correspondence outlining claim activity and next steps
• Calculate and pay approved claims
• Maintain confidentiality of client and corporate records and medical claims information

Qualifications

• 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

Compensation

At the time of this posting, the estimated annual base salary for this position is $68,000 - $75,000. Individual compensation within this range is determined by factors such as job-related skills, relevant experience, and education/training. This range reflects the annual base salary only and does not encompass the comprehensive total rewards package that we proudly offer.

Benefits

• Generous paid time off including 3 weeks minimum vacation, plus 26 long weekends a year through our much-loved Happy Friday program
• Flexible work options including remote and hybrid schedules
• Extended health and dental benefits
• RRSP matching
• Wellness support, including comprehensive mental health resources
• Clear career paths and personalized learning
• Leadership committed to invest in your development

Belonging Starts Here

Diversity, inclusion, and belonging aren’t just programs at DMI; they are our foundation. We foster a safe, respectful, and inclusive workplace where everyone belongs and can thrive.

If you need accommodation during any stage of the hiring process, please let us know! We’re here to help.

If you’re ready to do meaningful work and grow your career with DMI, we’d love to hear from you. Click Apply to submit your application.