Account Manager, Disability Claims
Munich Re
Munich Re, Toronto, Canada
5d ago

Your job

Claims Adjudication :

  • Conduct expert individual and group Short-Term and Long-Term Disability adjudication within internal standards, delegated authority limits and client response timelines;
  • Monitor coverage assessment including promptly identifying, addressing and resolving coverage matters;
  • Proactively investigate, assess, manage and resolve claim inconsistencies with clients;
  • Promptly approve payments in accordance with payment authorization protocols and client service level agreements;
  • Archive all claim documentation in an appropriate and orderly manner; proactively manage claim file follow up process.
  • Client Management :

  • Establish strongly positive, mutually beneficial, long-term client relationships through professional and knowledgeable communication;
  • Monitor client claim results and provide business partners with accurate client information on a timely basis through claim analytics, data mining and trend analysis;
  • Assist with identifying / implementing initiatives to enhance claim handling efficiencies and effectiveness;
  • Develop and implement strategies to track and improve deteriorating client claim results.
  • Risk Monitoring and Claim Reviews :

  • Identify and communicate exceptions to reinsurance treaty terms and claims where non-compliance exists to the internal business partners, and provide recommendations for resolution;
  • Perform client reviews according to reinsurance treaty contracts; produce excellent written analytical review reports with sound recommendations;
  • Conduct client review result presentations; follow up on recommended client actions to improve client review results;
  • Present claims to Senior Management for evaluation / authority including completion of pertinent claim summary reports and notice of high exposure claims.
  • Knowledge Transfer :

  • Create and deliver presentations and training programs for clients and internal business partners, via industry seminars or internal publications;
  • Provide technical mentoring on complex claims to other Claims team members;
  • Deliver leading-edge knowledge of group disability insurance claim investigations and practices to clients and internally.
  • Apply expert risk management knowledge to client claim situations and share expertise throughout the Munich Reinsurance Group e.

  • g. product development, contract wording;
  • Engage with pricing, underwriting, and legal to ensure treaty and contractual liabilities, product language and client decisions meet Munich Re’s risk standards and intent.
  • Your profile

    First and foremost, the successful candidate will be an accomplished Intermediate or Senior Case Manager who demonstrates a natural desire to provide exceptional disability case management through his / her knowledge, energy, enthusiasm and initiative.

    In addition, we are looking for the following qualifications :

  • University degree in combination with CEBS, CSPDM, FLMI or other insurance designations.
  • Minimum 7 years Group insurance experience with thorough knowledge of Group disability claims. Exposure to different group types (union and non-union for example) and complex claims is an asset.
  • Bilingual (English / French) is a preferred asset.
  • Exhibits thoroughness, accuracy and attention to detail in claim reviews and data capture.
  • Strong analytical and inquisitive skills; excellent attention to meeting time service and achieving deliverables.
  • High degree of self-motivation, continuing development and proven ability to work independently.
  • Demonstrated desire and aptitude to learn other lines of business and claim types.
  • Excellent presentation and report creation and delivery skills. Strong oral and written communication skills..
  • Demonstrated ability to build solid client relationships.
  • Related experience in reinsurance and knowledge of underwriting / medical concepts and terminology will be an asset.
  • Apply
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