Temp to Full Time Claims Examiner 100% remote Toronto or Calgary Job Overview You are an experienced Claims Examiner who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced setting providing excellent customer service in both the turnaround of the claim and handling emails and incoming calls. You will have the desire to develop an in-depth understanding of this position and be able to easily maneuver through numerous policies to accurately assess claims and inquiries.

You are a very strong team player.

The Claims

Examiner will be responsible for processing a variety of different claims and communicating these decisions to providers, members, and clients. This role requires strong time management skills, claims experience, and policy interpretation.

Responsibilities • Process travel insurance claims for medical, trip cancellation/interruption, baggage, dental and vision claims up to the designated limit • Adjudicate claims according to various benefit policies • Handle both inbound and outbound calls, complaints,



provide excellent customer service for claims matters both in person and via written correspondence • Work closely with claimants, providers, agents, brokers, other insurance carriers or their representatives • Work closely with other departments within the company on a day-to-day basis • Maintain accurate documentation on all claim files • Adjust reserves in accordance with the insurer’s guidelines • Present cases and participate in discussions during file reviews and appeals • Ensure all work complies with the PIPEDA and HIPAA • Support department initiatives and objectives • Provide guidance and mentorship to peers • Other related duties as assigned Qualifications and Education Requirements • High school diploma or University Degree or equivalent • Minimum 2-3 years of relevant travel insurance or medical insurance claims processing experience • Bilingual: English/French is required • Strong analytical and problem-solving skills • High level of proficiency in Microsoft Office suites • Superior verbal and written communication skills in English and/or French • Strong time management and organizational skills

📌 Claims Examiner (Toronto)
🏢 Profit Executive Search
📍 Toronto