Claims Examiner III, Creditor Life & Distribution

Company: CUMIS Union
Department: Creditor Claims
Employment Type: Regular Full-Time
Work Model: Hybrid (2 days in office)
Language: This role operates in English.

We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy.  That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose.  The best part is that you will work with people that care passionately about you, our clients and our communities.

The Claims Examiner III, Creditor Life and Disability adjudicates and manages a caseload of creditor Group Mortgage Protection (GMP) and Monthly Premium over $50,000 (MP) disability and life claims. This role is also responsible for adjudicating and managing claims for other creditor disability products including Loss of Employment (LOE), and where combined coverage exists, Single Premium (SP), Monthly Premium (MP) and Credit Card. This role assesses eligibility for disability and life benefits, develops case management plans, initiates, and implements interventions to minimize claim durations, authorizes and issues disability benefits.

• Through the review of current and historical medical information assess the initial insurance application to determine if a material misrepresentation (including fraudulent misrepresentation) has been made by the policyholder.
• For policies that are rescinded as a result of misrepresentation, communicate the decision to the appropriate parties including the policyholder.
• Ensure accuracy of, assess and review all information received in support of a new claim
• Interview claimants, employers, loans officers by telephone prior to making claim decisions
• Using the information received, the additional information gathered and the resources available and in accordance with policy provisions determine if the claim is payable.
• For each claim, develop and execute a proactive case management plan with the objective of minimizing the disability period.
• Initiate assessments and examinations where necessary.
• Proactively assess and review claims for change of definition including identifying alternative occupations and communicating change of definition decisions.

• Completion of a post-secondary diploma with 2 years customer service experience, 2 years disability claims management experience preferred.
• Medical anatomy College or University equivalent or ICA CI required.
• Completion of LOMA 280 & 290 required.
• ALHC, degree in a related discipline preferred.
• Knowledge of creditor products.

• You adapt to change and are committed to continuous improvement, in order to exceed client expectations.
• Your strong communication skills allow you to clearly convey messages.
• You’re an effective team player who shares knowledge to support your peers.

• You will be subject to a Background check as a condition of employment, in the event you are the successful candidate.

• Training and development opportunities to grow your career.
• Paid time off to support your personal and family needs.
• A holistic approach to your well-being, with a supportive workplace culture.
• Paid volunteer days to give back to your community.
• A comprehensive total rewards package, including competitive salary, pension and benefits.

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Expected salary range $83,936​

The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.​​

Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.

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