- 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
- Professional 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, robust 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 (Toronto)
🏢 Jobtailor
📍 Toronto