Catastrophic Claims Advisor

Posted 5 Hours Ago
Be an Early Applicant
3 Locations
Hybrid
Senior level
Fintech • Payments • Financial Services
The Role
Investigates, evaluates, negotiates, and manages complex catastrophic accident benefit claims. Guides clients through the claims process, coordinates with healthcare, legal, and rehabilitation stakeholders, supports functional recovery, resolves sensitive issues, manages disputes, applies accurate reserves, and ensures timely payments while complying with regulatory and contractual requirements.
Summary Generated by Built In

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professional, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. The Catastrophic Claims Advisor serves as a trusted guide and advocate for clients navigating complex catastrophic claims. Partnering with healthcare providers, legal representatives, rehabilitation specialists, and other key stakeholders, the advisor provides guidance, advocacy, and coordination throughout the claims process. Combining technical expertise with professionalism, empathy, and compassion, the role focuses on supporting each client's functional recovery, and ensuring their unique needs are met through a personalized, client-centered approach. You will be a key contributor to our mission of delivering exceptional claims service and client care. More specifically, you will be required to:

  • Investigate, evaluate and negotiate accident benefit claims of high complexity, ensuring compliance with regulatory and contractual obligations, as well as DGIG best practices 
  • Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims process 
  • Manage Catastrophic claims with a keen focus on functional recovery   
  • Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well-being 
  • Conduct settlement discussions and negotiate resolutions where appropriate 
  • Collaborate with internal and external legal counsel on LAT disputes, reconsiderations, judicial reviews, mediations, and hearings 
  • Collaborate effectively with internal and external stakeholders - such as medical professionals, legal representatives, and rehabilitation providers - to support client recovery and claim resolution 
  • Apply accurate reserving practices and ensure timely issuance of claim payments in accordance with company standards and best practices.  

What we offer*

  • Competitive salary and annual bonus
  • 4 weeks of flexible vacation starting in the first year
  • Defined benefit pension plan that provides predictable, stable income throughout retirement
  • Group insurance including telemedicine
  • Reimbursement of health and wellness expenses and telework equipment

*Benefits apply based on eligibility criteria.

#LI-Hybrid, #ON09*


What you bring to the table

  • Bachelor's degree in a related field 
  • A minimum of five years of relevant experience in accident benefits claim handling  
  • Please note that other combinations of qualifications and relevant experience may be considered 
  • Advanced experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery  
  • CIP designation or enrolled in the program  
  • Advanced proficiency of English due to the nature of the duties or work tools or because the position involves interactions with English-speaking partners, members and/or clients 
  • Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule)  
  • Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts and disability management principles 
Action oriented, Business insight, Complexity, Customer Focus, Decision quality, Differences, Interpersonal Savvy, Nimble learning


Equity, Diversity, Inclusion and Accessibility

At Desjardins, we believe in equity, diversity and inclusion. We're committed to welcoming, respecting and valuing people for who they are as individuals, learning from their differences, embracing their uniqueness, and providing a positive workplace for all. At Desjardins, we have zero tolerance for discrimination of any kind. We believe our teams should reflect the diversity of the members, clients and communities we serve.

If there's something we can do to help make the recruitment process or the job you're applying for more accessible, let us know. We can provide accommodations at any stage in the recruitment process. Just ask!

Trade Union (If applicable)

Job Family

Member/client sales and service (FG)

Unposting Date

2026-11-11

Skills Required

  • Bachelor's degree in a related field
  • Minimum five years of relevant experience in accident benefits claim handling
  • Advanced experience managing medical and disability files under the Statutory Accident Benefits Schedule, focused on functional recovery
  • CIP designation or enrollment in the CIP program
  • Advanced proficiency in English
  • Advanced knowledge of regulatory and contractual obligations, including the Statutory Accident Benefits Schedule
  • Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts, and disability management principles
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The Company
HQ: Lévis
40,858 Employees

What We Do

Desjardins Group is the largest cooperative financial group in North America and the fifth largest cooperative financial group in the world, with assets of $435.8 billion as at March 31, 2024. It was named one of Canada's Best Employers by Forbes magazine and by Mediacorp. To meet the diverse needs of its members and clients, Desjardins offers a full range of products and services to individuals and businesses through its extensive distribution network, online platforms and subsidiaries across Canada. Ranked among the world's strongest banks according to The Banker magazine, Desjardins has some of the highest capital ratios and credit ratings in the industry and the first according to Bloomberg News

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