Auto Express Care Claims Specialist – Level 1 APD
This role is responsible for reviewing, analyzing, evaluating and negotiating minor to moderate claims related to losses including accident benefits administration. The incumbent of this role is responsible for investigating these losses where necessary and assigning the appropriate independent adjuster and relevant experts to assist in the effective management and resolution of the claim.
WHAT WILL YOU DO:
- Monitor and respond to claims at all transaction levels including coverage, interpretation, evaluation, reserve adjustments, payments, written and verbal communication and internal reporting requirements.
- Review claim queries and complaints and take action where necessary.
- Coordinate support where required, when managing complex queries or complaints.
- Ensure fulfillment of claims satisfaction with insured through investigative techniques and work towards correcting deficiencies where possible.
- Communicate company positioning on issues to insureds, brokers and vendor partners.
TOOLS / TECHNOLOGIES:
- Working knowledge and ability of reading and interpreting all relevant policy wordings including the OAP, and most OPCF endorsements
- Working understanding of reserve calculation and exposure practices
- Working understanding of liability exposure and subrogation opportunities
- Working understanding of vendor network and required coordination in effective claims resolution
- Working knowledge of injury exposure and required reporting processes
- Access to a private, quiet, remote workstation, with reliable internet access.
- Completion of Ontario Secondary School Diploma is required.
- Great organizational skills and the ability to multitask is required.
- Thorough attention of detail is a must to ensure accuracy of claims documents, policy coverage interpretation and recognition of financial exposure.
- Ability to perform moderate mathematical calculations is required.
- Effective communication skills: verbal, non-verbal and written.
- Sound morals, ethics and confidentiality with ability to develop trusting and effective working relationships with peers and employees.
- The ability to exercise confidentiality and empathy are required when dealing with insureds and claimants.
- Strong problem-solving skills and negotiating skills are required for this position.
- Strong computer literacy, proficiency in all Microsoft Office programs and Internet navigation.