95 Claims Advisor jobs in Canada

Job Description

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we've always set ourselves apart as a modern mutual that does good. Now, we're proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we'll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us.

The Claims Specialist, Subrogation position is pivotal in handling Subrogation files of significant severity and complexity across all lines of business, including Auto, Property, Commercial, and Liability. The Claims Specialist will be entrusted with a diverse range of tasks. They will be responsible for investigating, reviewing, evaluating, negotiating, and settling Recovery files. Additionally, they will serve as the technical resource for all Recovery Adjusters, overseeing file handling by the recovery team, onboarding new Recovery Staff and training existing staff. The role also includes serving as Recovery's Pre-Arbitration Officer, managing all Arbitration matters within the Recovery Team.

This position requires an individual with strong judgment and analytical skills to maximize recovery results while providing superior customer service. The ideal candidate should have experience in litigation and working with external vendors, Counsel, Engineers, etc., in adherence to Gore Mutual's internal policies and procedures. Given that files may be pursued through inter-company arbitration or litigation, a robust litigation background involving Subrogation Files is essential.

The successful candidate will be expected to attend Settlement Conferences, Mediations, Pre-Trials, and Trials, providing settlement instructions to legal counsel to proactively resolve files as efficiently as possible. Beyond these responsibilities, this role involves mentoring and training initiatives for the Recovery team and front-line staff. The Claims Specialist will play an active role in staff engagement, creating and delivering onboarding training for new and existing staff to continually educate on new processes and key initiatives.

As the most senior role in Recovery claims handling, this position is uniquely positioned to offer insights into new strategic initiatives and opportunities for performance improvement. It is expected to deliver cost control through the management of files in litigation, managing risk and exposure to the Company. The Specialist Adjuster is expected to contribute to the overall success of the team and provide their technical expertise in file handling best practices to the Recovery staff.

Job Responsibilities:

• Handle large complex recovery files
• Review, investigate and assess new claims as they are referred and ensure that required expert vendors are involved in a timely manner.
• Ensure that responsible parties are placed on notice and the Demand and Subrogation Documents are sent to the responsible parties accordingly.
• Engage legal counsel as soon as the need is identified and that legal limitation dates are protected where we intend to pursue recovery or are still investigating, while also ensuring our clients are kept apprised of recovery efforts.
• The Recovery Specialist will also handle Employee Recovery files as required.
• Attend settlement conferences, mediation, pre-trials and trials
• attend settlement conferences, mediation, pre-trials, and trials as required with our legal counsel.
• Provide settlement instructions to legal counsel in pro-active efforts to resolve files as soon as possible using Alternative Dispute Resolution such as mediation/arbitration when possible.
• Mentoring of the Recovery team
• Act as a technical resource for all Recovery Adjusters and lead team training initiatives.
• Participate in succession planning for your role within the Recovery team.
• Oversee handling of files by the Recovery Adjusters and Intermediate Recovery Adjusters to ensure they are given opportunities to learn how to manage complex/litigated files.
• Arrange and lead round table discussions on successful and unsuccessful Recovery files so that all team members can learn from them.
• May assist with the completion of Technical File Reviews and may assist with the triage of new Recovery referrals.

• Act as a Training Resource for First Party Handlers on Recovery
  • Work with Training specialist and L&D to educate front line claims handlers on Recovery opportunities and how they can learn to identify Subrogation and make referrals in a timely manner.
  • Work with leaders of each line to provide regular training to their teams and to keep Recovery a focus for them.

• Pre-Arbitration Officer
  • When required, the Recovery Specialist is expected to act as Gore Mutual's Pre-Arbitration officer and handle all pre-Arbitration and Arbitration matters within Recovery if the file is $50,000 or less (or more if agreed by both insurers) and the third-party insurer is signatory to CICMA Arbitration agreement on files with an impasse on negotiation.
  • Prepare files for pre-Arbitration for inter-company Arbitration process and attend hearings when possible and where pre-Arbitration does not resolve the matter.

What you need to be successful:

• College or University diploma.
• CIP, FCIP, CSRP industry designations, or law degree is nice to have.
• 5+ years of insurance claims subrogation experience.
• Well experienced with Auto claims, Property claims, and Casualty claims.

Hybrid: We are a hybrid company and work 2 days per week in-office. This role has the flexibility to attend either our Cambridge or Toronto office.

#LI-HYB & #INDHP

Accessibility for applicants

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process.

If you require accommodation because of a disability, we will work with you to meet your needs. Contact us and a human resources representative will consult with you to determine an appropriate accommodation.

Should you request an accommodation during the interview process, please notify your Talent Acquisition Consultant.

Job Description

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we've always set ourselves apart as a modern mutual that does good. Now, we're proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we'll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us.

The Claims Specialist, Subrogation position is pivotal in handling Subrogation files of significant severity and complexity across all lines of business, including Auto, Property, Commercial, and Liability. The Claims Specialist will be entrusted with a diverse range of tasks. They will be responsible for investigating, reviewing, evaluating, negotiating, and settling Recovery files. Additionally, they will serve as the technical resource for all Recovery Adjusters, overseeing file handling by the recovery team, onboarding new Recovery Staff and training existing staff. The role also includes serving as Recovery's Pre-Arbitration Officer, managing all Arbitration matters within the Recovery Team.

This position requires an individual with strong judgment and analytical skills to maximize recovery results while providing superior customer service. The ideal candidate should have experience in litigation and working with external vendors, Counsel, Engineers, etc., in adherence to Gore Mutual's internal policies and procedures. Given that files may be pursued through inter-company arbitration or litigation, a robust litigation background involving Subrogation Files is essential.

The successful candidate will be expected to attend Settlement Conferences, Mediations, Pre-Trials, and Trials, providing settlement instructions to legal counsel to proactively resolve files as efficiently as possible. Beyond these responsibilities, this role involves mentoring and training initiatives for the Recovery team and front-line staff. The Claims Specialist will play an active role in staff engagement, creating and delivering onboarding training for new and existing staff to continually educate on new processes and key initiatives.

As the most senior role in Recovery claims handling, this position is uniquely positioned to offer insights into new strategic initiatives and opportunities for performance improvement. It is expected to deliver cost control through the management of files in litigation, managing risk and exposure to the Company. The Specialist Adjuster is expected to contribute to the overall success of the team and provide their technical expertise in file handling best practices to the Recovery staff.

Job Responsibilities:

• Handle large complex recovery files
• Review, investigate and assess new claims as they are referred and ensure that required expert vendors are involved in a timely manner.
• Ensure that responsible parties are placed on notice and the Demand and Subrogation Documents are sent to the responsible parties accordingly.
• Engage legal counsel as soon as the need is identified and that legal limitation dates are protected where we intend to pursue recovery or are still investigating, while also ensuring our clients are kept apprised of recovery efforts.
• The Recovery Specialist will also handle Employee Recovery files as required.
• Attend settlement conferences, mediation, pre-trials and trials
• attend settlement conferences, mediation, pre-trials, and trials as required with our legal counsel.
• Provide settlement instructions to legal counsel in pro-active efforts to resolve files as soon as possible using Alternative Dispute Resolution such as mediation/arbitration when possible.
• Mentoring of the Recovery team
• Act as a technical resource for all Recovery Adjusters and lead team training initiatives.
• Participate in succession planning for your role within the Recovery team.
• Oversee handling of files by the Recovery Adjusters and Intermediate Recovery Adjusters to ensure they are given opportunities to learn how to manage complex/litigated files.
• Arrange and lead round table discussions on successful and unsuccessful Recovery files so that all team members can learn from them.
• May assist with the completion of Technical File Reviews and may assist with the triage of new Recovery referrals.

• Act as a Training Resource for First Party Handlers on Recovery
  • Work with Training specialist and L&D to educate front line claims handlers on Recovery opportunities and how they can learn to identify Subrogation and make referrals in a timely manner.
  • Work with leaders of each line to provide regular training to their teams and to keep Recovery a focus for them.

• Pre-Arbitration Officer
  • When required, the Recovery Specialist is expected to act as Gore Mutual's Pre-Arbitration officer and handle all pre-Arbitration and Arbitration matters within Recovery if the file is $50,000 or less (or more if agreed by both insurers) and the third-party insurer is signatory to CICMA Arbitration agreement on files with an impasse on negotiation.
  • Prepare files for pre-Arbitration for inter-company Arbitration process and attend hearings when possible and where pre-Arbitration does not resolve the matter.

What you need to be successful:

• College or University diploma.
• CIP, FCIP, CSRP industry designations, or law degree is nice to have.
• 5+ years of insurance claims subrogation experience.
• Well experienced with Auto claims, Property claims, and Casualty claims.

Hybrid: We are a hybrid company and work 2 days per week in-office. This role has the flexibility to attend either our Cambridge or Toronto office.

#LI-HYB & #INDHP

Accessibility for applicants

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process.

If you require accommodation because of a disability, we will work with you to meet your needs. Contact us and a human resources representative will consult with you to determine an appropriate accommodation.

Should you request an accommodation during the interview process, please notify your Talent Acquisition Consultant.

Job Description

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we've always set ourselves apart as a modern mutual that does good. Now, we're proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we'll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us.

The Property Claims Specialist is responsible for investigating, evaluating, negotiating, and settling large, complex, and often litigated property claims. This role requires a high level of expertise in property insurance, exceptional analytical skills, and the ability to manage a demanding caseload independently. The ideal candidate will possess strong communication, negotiation, and problem-solving abilities, with a focus on delivering fair and timely resolutions while mitigating company risks. Above technical knowledge and skills, the Specialist's focus is on delivering a positive claims experience to Gore's customers, thereby strengthening our brand. In addition to core responsibilities, this role actively participates in key committees, advising on coverage interpretation and strategic responses that shape business outcomes. The adjuster also serves as a mentor and coach, supporting professional development and fostering expertise within the team to enhance overall capability.

Job Responsibilities:

Claims Investigation and Assessment

• Conduct thorough investigations of complex property claims, including but not limited to, large residential losses, multi-peril claims, and claims in litigation and dispute.
• Determine coverage applicability by analyzing complex policy language, endorsements, and exclusions.
• Interview policyholders, witnesses, and other relevant parties to gather information.
• Secure and analyze all necessary documentation, such as police reports, fire reports, appraisals, repair estimates, and financial records.
• Coordinate and direct external experts (e.g., engineers, forensic accountants, contractors, attorneys) as needed for specialized investigations and evaluations.
• Assess damages accurately, considering various factors such as depreciation, actual cash value, and replacement cost.

Claim Evaluation & Resolution

• Formulate comprehensive claim strategies for resolution, often involving complex liability and damage assessments.
• Accurately evaluate claim reserves based on investigation findings and potential future costs.
• Negotiate effectively with policyholders, attorneys, public adjusters, and other parties to reach fair and equitable settlements.
• Identify and pursue subrogation opportunities where applicable.
• Prepare detailed reports, including coverage analyses, damage assessments, and settlement recommendations.
• Manage claims within established authority limits, escalating to management as required.

Litigation Management

• Actively participate in the litigation process for assigned claims, working closely with defense counsel.
• Attend mediations, arbitrations, depositions, and trials as a company representative.
• Provide expert testimony when required.
• Develop and implement litigation strategies to minimize exposure and achieve favorable outcomes.

Customer Service and Communication

• Maintain regular and clear communication with policyholders, agents, and all involved parties, providing updates on claim status and explaining complex information in an understandable manner.
• Manage sensitive situations with empathy and professionalism, even during contentious negotiations.
• Adhere to all regulatory and company guidelines for claims handling.
• Build rapport and trust with claimants to facilitate a positive claims experience.

Risk Mitigation and Continuous Improvement

• Stay current with industry trends, changes in insurance law, and best practices in claims handling.
• Maintain all required licenses and certifications.
• Participate in ongoing training and professional development programs.
• Participate in post-loss reviews and team discussions to share insights and lessons learned.
• Stay informed about industry developments and regulatory changes that may impact claims handling

What you need to Succeed:

• 5-10 years property claims adjusting experience
• College or University education
• Demonstrated ability to handle complex property claims including claims with multiple parties, litigation, or high value.
• Exceptional communication, problem solving, negotiating, and decision making skills.

Hybrid: This is a hybrid role with the requirement to attend our Cambridge, ON or Vancouver, BC office twice per week.

Salary Range: The base salary range for this role is $65,500 - $121,000 per year.

#LI-HYB & #INDHP

Accessibility for applicants

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process.

If you require accommodation because of a disability, we will work with you to meet your needs. Contact us and a human resources representative will consult with you to determine an appropriate accommodation.

Should you request an accommodation during the interview process, please notify your Talent Acquisition Consultant.

Job Description

Department : Claims

Location: Toronto

Reports To : Manager, Claims

Company Overview:

Liberty Mutual Canada is the Canadian operation of Liberty Mutual Insurance Company. We offer a broad suite of commercial insurance products and solutions to mid-size and large Canadian companies with Canadian, North American and/or multinational risks. Liberty Mutual Canada has over 300 employees and services its clients coast-to-coast from our regional offices in Vancouver, Calgary, Edmonton, Toronto, Montreal and Halifax.

At Liberty Mutual Canada, diversity is about all of us. Our promise to you is a culture that is collaborative, rewarding and empowering. We are committed to attracting and retaining employees across all dimensions of diversity and believe that recognizing, appreciating, and applying the unique insights, perspectives and backgrounds of each person cultivates an atmosphere of trust and respect. At Liberty Mutual Canada, our values are to foster a high-performing, equitable and inclusive culture where the best talent of all backgrounds can bring their whole selves to work and succeed.

If you are unsure whether or not your experience matches every requirement below, we encourage you to apply anyway. We are looking for varied and diverse perspectives and experiences that we can add to our team!

Our core values guide all of our decision-making and come to life through our benefits and employee programs. We offer:

- A premier flexible work environment (a combination of on-site & remote work) supporting our employees in their pursuit of a healthy work-life balance

- Competitive health & dental benefits plan

- Market-leading pension plan

- Competitive time off policy

- External education & tuition reimbursement programs

- Employee & Family Assistance Programs

- An opportunity to get involved and become a member of one of our national employee committees – social responsibility, employee engagement, diversity, equity & inclusion

The Opportunity:

We are seeking a self-driven, client-focused Associate Claims Specialist to join Liberty Mutual Canada’s Toronto Claims team. This role will be responsible for managing all administrative duties within the Claims department, responding to emails, telephone calls, providing service to policy holders, brokers, claimants and internal customers, including underwriters and claims specialists. If you are an organized individual looking to grow their career in Claims, please read further!

Duties and Responsibilities:

• Act as administrative support for the claims department, including but not limited to claims programs, maintaining inboxes, reporting, and closing letters.
• Responsible for ensuring all new claims are set-up correctly in various systems depending on the claim type, including policy information, coverage, insurer and loss details.
• Responsible for ensuring all correspondence including follow up emails and responses are completed in a timely manner with insured and brokers.
• Processing vendor payments.
• Liaison with Underwriting as required.
• Complete all other administrative and service duties within the claims department as assigned.

Skills & Qualifications:

• Bachelor’s Degree or College Diploma and/or equivalent training.
• 1+ years of related industry and/or claims experience would be an asset.
• Strong interpersonal, presentation and communication skills (both oral and written).
• Bilingual in English and French is an asset
• Excellent computer skills required: specifically, Word and Excel. Comfortable with learning various computer systems and managing electronic files.
• Strong organizational skills and excellent attention to detail.
• Strong prioritization and decision-making skills.

Liberty Mutual Canada is committed to fostering an inclusive, accessible environment where all employees feel valued and supported. We are committed to building a workforce that is representative of the communities we operate in and serve. If you require an accommodation for the recruitment/interview process due to a disability (which may be invisible or visible, temporary or permanent), please let us know and we will work with you to meet your needs.

Job Description

Company Description

We believe in the power of work. Since 1994, we’ve been partnering with governments and local agencies across Canada to create sustainable employment opportunities for people, businesses and communities. We understand that work gives hope, strengthens relationships and drives economic growth.

About the role

Location: Work from home (must be in Canada)

Like WCG, you believe in the power of work to transform lives. As Claims Specialist, you’ll be responsible for answering client telephone inquiries about their claims, processing claims, and invoicing Veterans Affairs Canada. This is a customer service and clerical role that will suit a detail-oriented individual who is willing to learn. This position requires a high level of confidentiality pertaining to client records and financial information. 

What you’ll do

• Work with the User Support Team to resolve participant claim issues by responding to questions and resolving tickets in our ticketing system
• Provide back up for User Support Team as needed – answering calls from participants and service delivery staff
• Process client claims and service provider invoices in case management system accurately and ensures contractual and legislative requirements are met
• Review, process, and invoice all RSVP services to the contractual standard as needed
• Provide quality assurance for claims/invoices processed by other Claims Specialists
• Answer inquiries from field staff regarding claims and other administrative questions via phone and secure message
• Prepare cheques and EFT payments
• Filing, mailing, scanning and other administrative tasks

What you bring

• Bilingual English/French
• Proficient in MS Excel and Word
• Ability to prioritize and problem solve
• Ability to work independently and in a team environment
• Willingness to learn and enhance skills
• Strong interpersonal skills
• Detail oriented in a fast-paced continually changing environment
• Previous experience in claims processing or financial services environment
• High level of confidentiality; employment contingent on Security Clearance – Reliability Status

For complete job requirements, see the full Job Description here.

What we offer

• Competitive salary of $48,125 - $50,365 per year (based on full-time hours)
• Comprehensive and flexible health and dental benefits
• RRSP Matching program of 1.5% base earnings
• Ongoing learning and development opportunities
• Generous time-off policies that promote work/life balance
• A diverse and inclusive workplace with a track record of high employee engagement and teamwork
• The opportunity to do work that makes a difference!

ICRSVPADMIN

Diversity, Equity, Inclusion and Belonging Matter

WCG is strengthened by diversity. We are committed to achieving a workplace that is equitable and representative of Canada’s diverse population. We actively work to attract, develop, and retain employees from diverse and equity-deserving backgrounds who have exceptional ability and the desire to make a difference. We continuously strive to support individual needs and differences in a work environment that is built on inclusivity and respect for everyone.

WCG is committed to providing an accessible, barrier free recruitment and selection process. If contacted for an employment opportunity, please advise us if you require accommodation in advance of any part of the recruitment and selection process.

Passion and Lived Experience Matter!

If you don’t quite have the above credentials but feel passionate about this role and your ability to do it successfully, please APPLY ANYWAY! Tell us in your application why you believe you would be a great fit. We believe in developing talent and have a wide range of opportunities to support passionate team members as they grow towards their employment goals.

Job Description

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we've always set ourselves apart as a modern mutual that does good. Now, we're proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we'll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us.

The Property Claims Specialist is responsible for investigating, evaluating, negotiating, and settling large, complex, and often litigated property claims. This role requires a high level of expertise in property insurance, exceptional analytical skills, and the ability to manage a demanding caseload independently. The ideal candidate will possess strong communication, negotiation, and problem-solving abilities, with a focus on delivering fair and timely resolutions while mitigating company risks. Above technical knowledge and skills, the Specialist's focus is on delivering a positive claims experience to Gore's customers, thereby strengthening our brand. In addition to core responsibilities, this role actively participates in key committees, advising on coverage interpretation and strategic responses that shape business outcomes. The adjuster also serves as a mentor and coach, supporting professional development and fostering expertise within the team to enhance overall capability.

Job Responsibilities:

Claims Investigation and Assessment

• Conduct thorough investigations of complex property claims, including but not limited to, large residential losses, multi-peril claims, and claims in litigation and dispute.
• Determine coverage applicability by analyzing complex policy language, endorsements, and exclusions.
• Interview policyholders, witnesses, and other relevant parties to gather information.
• Secure and analyze all necessary documentation, such as police reports, fire reports, appraisals, repair estimates, and financial records.
• Coordinate and direct external experts (e.g., engineers, forensic accountants, contractors, attorneys) as needed for specialized investigations and evaluations.
• Assess damages accurately, considering various factors such as depreciation, actual cash value, and replacement cost.

Claim Evaluation & Resolution

• Formulate comprehensive claim strategies for resolution, often involving complex liability and damage assessments.
• Accurately evaluate claim reserves based on investigation findings and potential future costs.
• Negotiate effectively with policyholders, attorneys, public adjusters, and other parties to reach fair and equitable settlements.
• Identify and pursue subrogation opportunities where applicable.
• Prepare detailed reports, including coverage analyses, damage assessments, and settlement recommendations.
• Manage claims within established authority limits, escalating to management as required.

Litigation Management

• Actively participate in the litigation process for assigned claims, working closely with defense counsel.
• Attend mediations, arbitrations, depositions, and trials as a company representative.
• Provide expert testimony when required.
• Develop and implement litigation strategies to minimize exposure and achieve favorable outcomes.

Customer Service and Communication

• Maintain regular and clear communication with policyholders, agents, and all involved parties, providing updates on claim status and explaining complex information in an understandable manner.
• Manage sensitive situations with empathy and professionalism, even during contentious negotiations.
• Adhere to all regulatory and company guidelines for claims handling.
• Build rapport and trust with claimants to facilitate a positive claims experience.

Risk Mitigation and Continuous Improvement

• Stay current with industry trends, changes in insurance law, and best practices in claims handling.
• Maintain all required licenses and certifications.
• Participate in ongoing training and professional development programs.
• Participate in post-loss reviews and team discussions to share insights and lessons learned.
• Stay informed about industry developments and regulatory changes that may impact claims handling

What you need to Succeed:

• 5-10 years property claims adjusting experience
• College or University education
• Demonstrated ability to handle complex property claims including claims with multiple parties, litigation, or high value.
• Exceptional communication, problem solving, negotiating, and decision making skills.

Hybrid: This is a hybrid role with the requirement to attend our Cambridge, ON or Vancouver, BC office twice per week.

#LI-HYB & #INDHP

Accessibility for applicants

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process.

If you require accommodation because of a disability, we will work with you to meet your needs. Contact us and a human resources representative will consult with you to determine an appropriate accommodation.

Should you request an accommodation during the interview process, please notify your Talent Acquisition Consultant.

Job Description

Disability Claims Specialist

$65,000-80,000

Vancouver BC

ABOUT US

STRIVE is a Vancouver-based recruitment firm specializing in Accounting & Finance, Corporate Administration, and Operations. We pride ourselves on a transparent, genuine, and consultative approach. Our proactive recruitment strategy enables us to connect with high-caliber professionals for specialized and often hard-to-fill roles. Our philosophy centers on deeply understanding both client and candidate motivations, requirements, and objectives.

THE ROLE

Were partnering with a reputable organization that provides administrative support for employee benefit programs, including disability case management. This role sits within the Claims department, supporting a team dedicated to ensuring timely and accurate adjudication of disability claims across British Columbia. You will report to the Manager of Disability & Benefits, and contribute to delivering exceptional service in a fast-paced environment. As a Disability Claims Specialist, you will be responsible for the end-to-end handling of disability claims, ensuring timely adjudication and seamless service delivery to plan members. This role requires a high level of attention to detail, empathy, and sound judgment, as youll be working closely with both internal teams and external stakeholders to manage complex cases with care and accuracy.

Responsibilities:

• Managing a caseload of short- and long-term disability claims, including eligibility assessments, documentation review, and decision-making in accordance with policy and legislation
• Coordinating directly with claimants, healthcare providers, and external consultants to gather medical information and support return-to-work planning
• Reviewing and approving benefits payments while maintaining accurate and up-to-date claim records
• Ensuring all claims are handled in a timely and compliant manner, meeting internal service standards and regulatory requirements
• Providing clear, professional communication to claimants and stakeholders throughout the claims lifecycle
• Identifying opportunities to improve internal processes and contributing to the ongoing refinement of case management practices
• Collaborating with HR, benefits administrators, and third-party vendors to ensure smooth claims transitions and continuity of care
• Maintaining the confidentiality and security of all personal and health-related information in line with privacy legislation

Requirements:

• A post-secondary degree in a relevant field; a CEBS designation (or progress toward it) is considered a strong asset
• A minimum of 3 years experience in disability claims management, benefits adjudication, or a related group benefits or insurance environment
• Solid understanding of medical terminology, disability plan provisions, and applicable legislation
• Strong organizational and case management skills, with the ability to handle sensitive information and competing priorities
• Proficiency in Microsoft Office (particularly Excel and Outlook) and familiarity with claims or case management systems
• Excellent communication and interpersonal skills - able to liaise professionally with claimants, healthcare providers, and internal teams
• High attention to detail, strong documentation habits, and the ability to make sound, timely decisions
• A team-oriented mindset with a commitment to service excellence and confidentiality

Job Description

CONTENT CLAIMS SPECIALIST (Bilingual: English | French)
We are hiring an in-house bilingual content claims specialist to join our team remotely in Canada.
The position location is flexible, and we can offer in-office, hybrid, or fully remote working arrangements .

Candidates in Quebec must have some AMF courses completed. In Ontario at least 4 CIP courses completed.

Montreal, Quebec
3-6 years of experience
Claims - Insurance Industry

QUALIFICATIONS

• Strong communication skills.
• Willingness to learn and continuously improve.
• Be able to provide an adequate workspace, free of noise.
• Demonstrated ability to adapt to change and new technology.
• Employee must provide their high-speed internet service.
• Ability to communicate effectively verbally and in writing in both French and English.
• A Secondary School diploma background/experience in the property claims industry would be considered an asset.
• Company equipment will be provided. It is the employee’s responsibility to care for and maintain the equipment, as per policy.

JOB DESCRIPTION

• The role of Contents Claims Specialist is a multi-faceted role, which focuses primarily on the following four key areas of adjuster’s content claims handling operations:
• Acting/operating as a third party, intermediary between the Insurance Company’s property adjusters and their policyholders concerning conducting fair market assessments and valuations of policyholders’/claimants’ total loss personal contents, which are most commonly caused by theft, water, fire, and other perils.
• Operating from their home-based offices, adjusters’ Content Claim Specialists are responsible for recording all daily claims handling activity, concerning hours worked/time spent per task, as well as fulfilling all of their required administrative job duties.
• Focusing on the accurate and timely processing of the industry’s major loss and damage content claims, via the use of adjusters’ claims handling professional-service methodology and its Web-based content claims processing and pricing platform/system – exclaim. Operating from their appropriately set up and equipped home-based offices, Adjuster’s Contents Claims Specialists are consistently (daily/weekly basis) assigned new claim files.

RESPONSIBILITIES

• Report/record all time spent on each claim file on a consistent and daily basis.
• Consistently promote the adjuster's brand, image, and reputation professionally and positively.
• Perform according to the Company's performance/productivity standards on each task and every claim.
• Must have and maintain a high-speed internet connection to work with the adjuster's website and the equipment provided.
• Consistent and quality turnaround of all claims by the Company’s productivity and performance standards.
• Conduct ongoing new research and price contents from completed claims inventories, the schedule of loss forms, and from contractors’ lists.
• Perform other tasks and claims-related functions from time to time, and as directed by the Company’s Manager, In-house Operations.
• Submit completed claims reports to Insurance adjusters, close files to meet adjusters' performance cycle times and productivity standards.
• Effective and professional communications with all key stakeholders in the claims process, including adjuster claims reps, adjusters, policyholders, and industry contractors.
• Maintain a 40-hour workweek when required and work is available, at the Manager’s request. This will vary and will be mandatory by operational requirements.
• Maintain claim related notes in the Company’s Claims System/Web-application (exclaim), relating to incurred hours over productivity standards, as well as related to specific issues and other pertinent notes.
• Conduct data entry, research, and pricing of higher-valued, personal contents based on like, kin, and quality pricing, and working with various means of researching fair market pricing via suppliers, Internet, databases, sand other means.