This role requires flexibility with working hours between 8:00 a.m. and 8:00 p.m., Monday to Friday to accommodate hours of operation for the telephone queue and may also be required to support changing conditions, customer demands, and business needs.
The Claims Specialist will be responsible for the coordination of all claims received through the Broker Account. This is a client service role that will interact extensively with various parties involved in the claim process including Brokers, Insurance companies, Insureds, Adjusters as well as corporate office team members. In addition to claims intake and file coordination, this role must represent itself as a Claims Partner and advocate for the Broker client to ensure a successful claim experience.
Responsibilities will include:
Claims Intake/Setup (40%)
• Maintain daily access in the telephone queue in accordance with company expectations, for intake of new claims.
• Intake and setup of new claims through email, telephone contact or after-hours assignment.
• Gather and coordinate necessary documentation and information related to the claim in order
to create a notice of loss and distribute to appropriate Carrier reporting channels within established timelines.
• Input and setup new claims to the Broker and operating systems.
• Triage claims via email, fax, web submission, and/or telephone in accordance with the Broker Claim Services Agreement and protocols.
• Adhere to and maintain file diary schedule in the Broker operating system. Diaries for all claims setup must be kept current and relevant at all times (includes calls that do not develop into a claim).
• Adhere to system / telephone standards and achieve and maintain performance /productivity metrics.
• Cross-train Junior Claims Specialist to support Broker account as necessary.
• Provide support on all other accounts by assisting with backlog of intake and setting up claims from the telephone queue.
• Other duties as required in order to support the team.
File Coordination (40%)
• Maintain regular contact with Carrier, Adjusters and Examiners by telephone or email to obtain open claim status information and access electronic file and Broker operating systems
concurrently; support the Adjuster in keeping the client up-to-date.
• Manage all incoming claim correspondence from Carriers or Adjusters to update the status of claims. Incoming correspondence and or documents must be input into the
operating system and cleared within 5 days of receipt.
• Provide Management Reports for corporate office and Broker Accounts as requested.
• Other duties as required
Claims Advisor (20%)
• Advise, guide and answer questions on the claim process to the Broker Client through
telephone/email contact or in-person.
• Through contact with Carrier Adjuster/Examiner advocate for the Broker Client regarding the process.
• Respond to Broker Client calls received directly following claim setup and answer questions on behalf of the Broker.
• Advise Insureds of no coverage (in consultation with their Broker) in a professional and empathetic manner in order to rectify problems on their own and/or support looking after their needs.
• Other duties as required.
Interested candidates, please contact Otis Wong at firstname.lastname@example.org. If you are working with another DGA recruiter, please feel free to ask them about this position.
Founded in 1986, DGA Careers specializes in providing insurance recruiting services to major insurers, insurance brokerage firms and independent adjusting firms. DGA Careers assists qualified professionals in claims, underwriting, sales, customer service, and more, connect with the Canadian insurance industry at all levels. We endeavour to respond to each applicant in a timely manner