Accident Benefits Claims Advisor
$58.8k - $83k per yearTD
Lieu de Travail
Markham, Ontario, Canada
Horaire
35 heures par semaine
Secteur d’activité
TD Assurance
Rémunération
$58 800 – $83 000 CAD (base salary; bonus variable et avantages sociaux compris)
Description du poste
Accident Benefits Claims Advisor
Au sein de l’équipe des réclamations d’accident, vous êtes responsable de la gestion d’un portefeuille de réclamations médicales : investiguer, évaluer l’éligibilité et les plans de traitement, et prendre des décisions de paiement. Vous aiderez les clients à traverser la phase de rétablissement en offrant un service rapide, juste et empathique.
Responsabilités clés
- Investiguer les réclamations en recueillant et en analysant les dossiers médicaux et les preuves de soutien
- Évaluer l’éligibilité et le droit aux prestations selon la police et les exigences réglementaires
- Évaluer les plans de traitement et formuler des recommandations alignées aux objectifs de rétablissement
- Identifier les lacunes ou les incohérences des informations et entreprendre les actions appropriées
- Gérer un portefeuille de réclamations avec un focus sur la qualité, la rapidité et la conformité
- Maintenir les réserves appropriées, prioriser les paiements et respecter les normes de documentation
- Servir de point de contact principal aux clients blessés, fournissant conseils clairs sur les prestations et les prochaines étapes
- Construire la confiance grâce à une communication empathique et professionnelle
- Veiller à ce que les clients aient un accès rapide aux traitements et services de soutien
- Atteindre les objectifs de productivité, y compris le volume de dossiers et les délais de clôture
- Collaborer avec les collègues et les équipes partenaires pendant les périodes à fort volume ou les événements critiques
- Contribuer à un environnement d’équipe inclusif et positif
Compétences et qualifications requises
- Analytique et logique de pensée critique
- Capacité à interpréter la documentation médicale et à prendre des décisions éclairées
- Excellentes compétences en communication écrite et verbale
- Expérience démontrée dans la gestion de plusieurs priorités dans un environnement rapide
- Formation en kinésiologie, sciences de la santé ou domaine connexe un atout
- Expérience dans les réclamations, l’assurance, les soins de santé ou les rôles en contact client préférable
- Connaissance de la terminologie médicale ou des concepts de rééducation privilégiée
- Organisation détaillée et structuration méthodique
- Capacité à prendre des décisions avec des informations incomplètes
- Empathie tout en restant objectif
- Motivation à aider les gens et résoudre des problèmes
Autres atouts
- Compétence dans la prise de décisions fondées sur des preuves
- Intérêt pour l’intersection santé–assurance – support client
- Gestion des situations émotionnellement sensibles avec professionnalisme et soin
- Ambition de bâtir une carrière durable en réclamations ou assurance
Informations supplémentaires
Travail sur site, 4 jours par semaine. Date de début prévue en septembre 2026.
Exigences linguistiques (Québec seulement) : Français.
#J-18808-LjbffrVacancy posted 8 days ago
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