Manage the claims experience to ensure accurate results that comply with team, department, company standards and provincial regulations; provide regular feedback to management.
Review insurance claims to verify accuracy, completeness, and eligibility; make recommendations to approve, deny, or refer claims based on policy language.
Analyze information to determine the extent of liability and make well-founded risk management decisions; oversee decisions made by claims associates.
Meet key business objectives and fulfill customer service expectations.
Provide technical oversight and guidance focused on cost control and optimizing the customer experience.
Take on leadership responsibilities supporting daily operations, contribute to process improvements and the overall success of the department.
Provide guidance on policy interpretation, analysis, and technical issues.
Resolve complex or high-value claims within authority, or escalate them as needed.
Continuously evaluate workflows to improve efficiency and support digital initiatives.
Collaborate with internal and external stakeholders to resolve issues and maintain positive relationships.
Work closely with the leadership team to develop strategies and long-term plans, enhancing processes, client relationships, and other functions.
Lead and actively contribute to a culture of continuous improvement by using tools and behaviors that promote critical thinking and innovation in problem-solving.
Perform monthly file reviews and audits, identify improvement opportunities, and develop action plans.

Requirements

Bilingual (French and English)
College diploma in Insurance and Financial Advisory Services
Hold an unrestricted certificate (no conditions)
Minimum 5 to 7 years' experience as a claims adjuster
Strong knowledge of legal principles and liability insurance policies
Hold an Autorité des marchés financiers (AMF) license for personal and commercial property and casualty insurance
Experience with Office 365 and Windows 10
Strong attention to detail
Excellent verbal and written communication skills
Strong analytical skills and mathematical knowledge
Ability to manage multiple priorities
Team player

Benefits

Health insurance
401(k) matching
Flexible work hours
Paid time off
Remote work options

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims managementrisk managementpolicy interpretationfile reviewsauditsliability analysiscost controlprocess improvementscustomer experience optimizationmathematical knowledge

Soft Skills

leadershipcommunicationanalytical skillsattention to detailproblem-solvingcollaborationcritical thinkingcustomer servicetime managementteamwork

Certifications

unrestricted certificateAutorité des marchés financiers (AMF) license