86 applicants

Company

Manulife · 7 hours ago

Disability Claims Adjudicator, Affinity Markets

CAN, Newfoundland - Full Time Remote

Full-time

Onsite

Entry, Mid Level

CAD$56K/yr - CAD$94K/yr

2+ years exp

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Responsibilities

Establish and maintain superior customer service to plan sponsors, policyholders, agents, marketing centers

Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.

Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements; administer policy enhancements, premium waiver and other policy benefits

Make decisions on claim benefit eligibility determination and communication decisions to stakeholders

Document the claim file to ensure an accurate record of events that transpire in the claim handling

Obtain proper file information and review with policy provisions to verify eligibility

Accurately maintain claim records on system to ensure accuracy of reserve calculations

Qualification

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Claims adjudicationMedical terminologyNegotiating skillsUniversity degreeFrench languageUnderwriting process knowledgeGovernment legislation knowledge

Required

University degree in any discipline or equivalent work experience.

2-3+ years’ experience in adjudicating claims, preferably disability and critical illness.

Customer service oriented individual with negotiating skills is essential.

Excellent interpersonal skills with good oral and written communication skills in English for use in dealing with internal and external customers, claimants, brokers, physicians, employees, hospitals, investigators and lawyers.

Must have a good working knowledge of medical conditions and terminology, as well as experience in the interpretation and application of financial documentation and fair claims practices.

Ability to respond constructively and decisively in high pressure or emotional situations and to respond positively to change.

Good working knowledge of the underwriting process.

Ability to thrive in a high energy culture.

Good analytical skills to evaluate conflicting information from various key sources in order to assess risk in making timely and effective decisions with appropriate.

Proven ability to make decisions and handle pressure.

You share your humanity – you like being part of a collaborative team and are open to diverse perspectives...and of course, you like to have some fun at work.

Preferred

Working knowledge of government legislation and legal precedents, the Insurance Act and/or Quebec Civil Code is an asset.

Ability to communicate in French is an asset.

Benefits

Health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans

Various retirement savings plans (including pension and a global share ownership plan with employer matching contributions)

Financial education and counseling resources

Generous paid time off program in Canada includes holidays, vacation, personal, and sick days

Full range of statutory leaves of absence