Full-Time Accident Benefit Specialist
Job Description
ACCIDENT BENEFIT SPECIALIST
To manage Ontario Accident Benefit claims which have proceeded into the litigation process using our claims philosophy and following our file management model.
• Inform claimants and representative of their entitlement and obligations under the Statutory Accident Benefits Schedule (SABS) while ensuring compliance with established company standards. Pending consists of files of a more complex nature that are in litigation, serious and/or meet catastrophic definition.
• Effective Management of our Defence Counsel as per our Litigation Guidelines for both strategy and budget.
• Investigate and evaluate claims to collect data and determine loss exposure. Forward necessary explanations and documents as per SABS.
• Ensure effective financial management. Establish case reserves and issue claim payments on a timely basis.
• Manage and interact with stakeholders in the claims process to ensure client’s rehabilitation needs are met (health practitioner, treatment provider, employer, lawyer, etc…) Interactions carried out on face to face basis.
• Effectively manage and negotiate claims through dispute resolution process.
• Oversee and provide instruction to defense counsel.
• Act as a company representative in arbitration and court hearings.
• Attend Claims Resolution and/or Claims Validation Meetings and complete large loss reports as required.
EDUCATION & TECHNICAL COMPETENCIES
• Post secondary education (University Degree or College Diploma) in Business, Health Sciences, or related field is preferred.
• A minimum of 7 years of Accident Benefits claims experience is required and must include the handling a pending of Litigation and Arbitration files.
• CIP Designation or enrolled in program preferred.
• Superior knowledge of Statutory Accident Benefits Schedule (SABS).
• Superior knowledge of medical and legal information and terminology.
• Proficient with our in-house & other computer systems (i.e., INDEM, MS Word, Excel, Lotus Notes)
• An advanced level of English (both written & verbal) is required.
Some travel throughout Ontario as necessary.
Assistance with an AB Lit role.
Hands on technical skills in AB Litigation, arbitration, communication and negotiation.
Must be comfortable working in a collaborate team based environment.
Min of 7 year AB with 3 – 4 years of hands on litigation experience.
I will be the main contact for this role
FEEL FREE TO DISCUSS CONTACY Peggy 647-765-4473
EMAIL DIRECT Peggy@dynateams.com
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