Job Posting

BRIEF DESCRIPTION: Reporting to the Manager of Claims, this full-time role is responsible for the adjudication of accident & health claims and related customer service.

RESPONSIBILITIES INCLUDE:

• Manage a portfolio of Medical, Disability and Critical Illness claims including oversight of reporting, notification, evaluation, case reserving, settlement and file closure.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution
• Settlement of claims within designated authority.
• Regular communication with the claimant and the client.
• Manage relationships with, and ensure appropriate handling by, external TPAs, adjusters and counsel.
• Identify process improvements and recommend changes to policies or procedures to improve quality of service and competitiveness.