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 environment 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 robust time management skills, claims experience, and policy interpretation.ResponsibilitiesProcess travel insurance claims for medical, trip cancellation/interruption, baggage, dental and vision claims up to the designated limitAdjudicate claims according to various benefit policiesHandle both inbound and outbound calls, complaints, provide excellent customer service for claims matters both in person and via written correspondenceWork closely with claimants, providers,



agents, brokers, other insurance carriers or their representativesWork closely with other departments within the company on a day-to-day basisMaintain accurate documentation on all claim filesAdjust reserves in accordance with the insurer's guidelinesPresent cases and participate in discussions during file reviews and appealsEnsure all work complies with the PIPEDA and HIPAASupport department initiatives and objectivesProvide guidance and mentorship to peersOther related duties as assignedQualifications and Education RequirementsHigh school diploma or University Degree or equivalentMinimum 2-3 years of relevant travel insurance or medical insurance claims processing experienceBilingual: English/French is requiredStrong analytical and problem-solving skillsHigh level of proficiency in Microsoft Office suitesSuperior verbal and written communication skills in English and/or FrenchStrong time management and organizational skills

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