Assess claims for benefit entitlement by reviewing contractual, medical, functional, and occupational documentation according to established routines and certificate provisions
Manage an active caseload in compliance with client service standards, best-practice guidelines, KPIs, and turnaround times
Document claim analysis thoroughly and maintain accurate records according to company policies and procedures
Communicate professionally and empathetically with stakeholders in writing and verbally
Provide updates, clarify claim status, and explain decisions
Conduct detailed phone interviews with clients or involved parties
Identify and obtain supporting documents for current and future benefit payments
Collaborate with team members, plan sponsors, and other stakeholders
Participate in departmental projects and continuous improvement initiatives
Identify process optimization opportunities and adapt to changes
Perform other related duties as assigned
Requirements Post-secondary education or equivalent work experience
College diploma (DEC) in a relevant field preferred
Skilled designations such as FLHC, FLMI, or ALHC considered assets
Minimum of 1 year experience in insurance claims processing, particularly in life, disability, and critical illness insurance
Medical knowledge obtained through claims assessment, underwriting, or experience in a medical or paramedical profession is an asset
Strong analytical and problem-solving skills
Meticulous attention to detail and commitment to high-quality service
Strong proficiency in English for communication with customers and colleagues




Strong proficiency in French for communication with customers and/or colleagues in Quebec
Ability to conduct sensitive phone interviews and convey decisions tactfully
Proficiency in Microsoft Office suite, including Word and Outlook, and case management software
Ability to multitask and prioritize effectively while meeting diverse deadlines
Professionalism under pressure and ability to manage stressful situations and deliver difficult news empathetically
Positive attitude, strong team spirit, and adaptability to organizational changes
Core Competencies Demonstrates expertise in insurance claims processing, particularly in life, disability, and critical illness insurance, with strong analytical skills and meticulous attention to detail. Proficient in conducting sensitive interviews and communicating effectively in both English and French.
Highest-signal resume keywords Insurance Claims Processing
Analytical Skills
Bilingual Communication (English and French)
Microsoft Office Proficiency
Professional Designations (FLHC, FLMI, ALHC)
ATS Optimization Keywords Hard Skills Claims Assessment
Documentation Management
Medical Knowledge
Problem-Solving
Case Management Software
Soft Skills Attention to Detail
Empathy
Team Collaboration
Adaptability
Professionalism Under Pressure
Certifications & Qualifications FLHC
FLMI
ALHC
Industry Keywords Benefit Entitlement
KPI Compliance
Continuous Improvement
Process Optimization
Client Service Standards
Tools & Technologies Microsoft Word
Microsoft Outlook

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📌 Claims Care Analyst, 12 Months Contract (Ontario)
🏢 Jobtailor
📍 Ontario