Claims Advisor, Accident Benefits

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professionals, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. In this role, you will manage accident benefit claims of moderate to high complexity, with a strong focus on functional recovery, client satisfaction and stakeholder collaboration. You will play a critical role in guiding clients through the claims process, ensuring their unique needs are met with professionalism and empathy. You will investigate, evaluate and negotiate accident benefits claims, while establishing and maintaining relationships with members and clients. You will be a key contributor to our mission of delivering exceptional claims service and client care. More specifically, you will be required to:
Investigate, evaluate and negotiate accident benefit claims of moderate to high complexity, ensuring compliance with regulatory and contractual obligations, as well as DGIG best practices
Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims process
Manage Disability claims with a keen focus on functional recovery and return to work
Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well-being
Collaborate effectively with internal and external stakeholders - such as medical professionals, legal representatives, and rehabilitation providers - to support client recovery and claim resolution
Apply accurate reserving practices and ensure timely issuance of claim payments in accordance with company standards and best practices.
What we offer*
Competitive salary and annual bonus
Salary range : $66 971 to $98 225 per year (Toronto suburbs)
4 weeks of flexible vacation starting in the first year
Defined benefit pension plan that provides predictable, stable income throughout retirement
Group insurance including telemedicine
Reimbursement of health and wellness expenses and telework equipment
* Benefits apply based on eligibility criteria.
What you bring to the table
Bachelor's degree in a related field
A minimum of three years of relevant experience in accident benefits claim handling
Please note that other combinations of qualifications and relevant experience may be considered
Intermediate experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery and return to work.
CIP designation or enrolled in the program
Advanced proficiency of English due to the nature of the duties or work tools or because the position involves interactions with English-speaking partners, members and/or clients
Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule)
Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts and disability management principles
Action oriented, Business insight, Complexity, Customer Focus, Decision quality, Differences, Interpersonal Savvy, Nimble learning, Tech savvy
Equity, Diversity, Inclusion and AccessibilityAt Desjardins, we believe in equity, diversity and inclusion. We're committed to welcoming, respecting and valuing people for who they are as individuals, learning from their differences, embracing their uniqueness, and providing a positive workplace for all. At Desjardins, we have zero tolerance for discrimination of any kind. We believe our teams should reflect the diversity of the members, clients and communities we serve.
If there's something we can do to help make the recruitment process or the job you're applying for more accessible, let us know. We can provide accommodations at any stage in the recruitment process. Just ask!
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This position is actually vacant.
Desjardins uses tools that incorporate artificial intelligence functionalities to screen or assess applicants as part of the recruitment process for this position.
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