Claims Adjudicator-Blended(ZISPL Job No 438)

Main Accountabilities: 

• Assess the documentation received for a claim in order to reach a decision 
• Determine how the contract applies to each claim 
• Communicate clearly and proactively with clients, advisors and various professionals and effectively manage their expectations 
• Maintain established service standards 
• Evaluate opportunities for process improvements and actively participate in team initiatives and projects 
• Act as a technical expert for clients, claims adjudicators, risk management and underwriters 
• Identifying complaints, acting upon them and resolving them in line with problem resolution guidelines 

Core Competencies: 

• Minimum 3 years in life claims adjudication 
• Experience handling contestable claims, accidental death benefits, and/or foreign death claims 
• In depth insurance technical knowledge 
• Confident and influential communicator with the ability to negotiate at all levels 
• Excellent written and verbal communication skills with an ability to handle written and telephone inquiries of a sensitive nature 
• Strong problem solving and analytical skills 
• Attention to detail 
• Team player with a positive attitude and commitment to provide quality service 
• The ability to build and manage cooperative and productive relationships 
• Solid PC skills with knowledge of Word, Outlook and Excel 

Requirements: 

• College diploma/university degree/CEGEP degree or relevant experience 
• Fluent in both French and English 
• In pursuit of LOMA, HIAA and ICA courses.