Group Claims – Program Manager

Group Claims – Program Manager     $80 – $85,000

Comma Recruitment are looking for an experienced Group Insurance Specialist, ideally with experience in Claims, this role will not be directly handling claims but requires a Program Manager to build relationships and manage and coordinate Group Programs.

This role is primarily responsible for working directly with clients and working many internal resources and departments to coordinate our services, as well as direct supervision of claims staff.

The Program Manager would also work with Account Executives, Client Service Representatives and/or other internal resources, as well as directly with our client base.

Responsible for:

• Managing group disability client block and claims staff; developing and maintaining long-term  relationships by providing excellent customer service and consultative support on Disability Programs.
• Driving growth within customer base. Tasks include:

Respond to client inquiries & service requests pertaining to their Disability programs and services . Supervise and evaluate staff (performance reviews). Plan, direct, monitor and oversee staff schedule, workload and deadlines.  Make modifications when needed to meet goals.

• Provide staff with support, advice, instructions, approval and resolution to unusual claims.
• Deal with complex, difficult / unusual inquiries, complaints and situations. Identify, define and take appropriate action to resolve.
• Ensure that objectivity, tact and clear written and verbal communications are maintained in highly sensitive situations.
• Attend client/broker/TPA meetings, as needed.
• Assist in defining, developing and implementing departmental policies and objectives.
• Responsible for the execution of Disability programs
• Responsible for program governance including review of internal reporting and  identification of issues
• Issuing reports to clients
• Managing the renewal process with appropriate internal teams
• Responsible for client support, annual planning preparation and meetings where appropriate
• Responsible for execution of group disability management program
• Act as a liaison with internal departments to resolve issues that may arise with clients
• Follow up on manager consultations
• Responsible for Customer Relationship Management

 

Qualifications and Experience:

• Detail oriented with strong organizational and time management skills
• Ability to perform multiple tasks effectively and concurrently
• Demonstrated ability to manage relationships and influence key stakeholders
• Demonstrated ability to work effectively under pressure and within a collaborative
• Team oriented environment using sound judgment in decision making skills
• Excellent verbal and written communication skills.
• Strong analytical and presentation skills
• Demonstrated performance consulting, leadership and management skills, and the ability to present to branch management an large groups with the capacity to conduct one-on-one training
• Demonstrated strong functional and technical skills and/or the ability to grasp technical concepts quickly
• Strong background in Group Disability Insurance

 

Education:

• 5-10 years of complex claims handling experience required;
• Preferable work experience in a client interactive claims capacity role
• Strong development, facilitation, and presentation skills preferred
• Demonstrated sound knowledge of the Group insurance industry, claims, and related client relationship experience preferred
• Proficient with the Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
• Coaching and mentoring background an asset
• Ability to be flexible, multi-task and work with limited direction

Please forward resume to [email protected]  

Bilingual Health Underwriter – GTA East

Bilingual Health Underwriter – GTA EAST

Comma Recruitment are looking for junior to senior Bilingual Health Underwriters, must be perfectly fluent in French and English with two years of similar work experience. Salary flexible and will depend on experience, great benefits package with vacation and superb work / life balance located GTA East

Your role will be to review, evaluate and assess all individual Disability applications for accuracy and completeness and accepts or declines the risk based upon analysis of medical history, occupational hazards, financial background, insurable interest or other information pertinent to the decision.

• Exercises sound and reasoned medical and financial underwriting judgments based on various underwriting requirements and case documentation.
• Communication with applicants/agents when information is missing or in error on the application.
• Communicates case decisions to applicants in a timely and customer-friendly manner.
• Submits recommendations for cases in excess of approval limits or for consultation to Medical Director or Manager.
• Orders requirements (Paramedical, laboratory, ECG, Vitals) as per Underwriting guidelines or due to medical history.
• Performs other related duties as assigned or required. 

Required Qualifications / Experience

• College graduate and around two years of relevant work experience.
• Solid knowledge of underwriting risk assessment, policies and procedures, medical terminology, human biology and anatomy
• Excellent written and verbal communication skills (communicate clearly and concisely by telephone and email) in English and French (Bilingual required).
• Strong organizational skills and attention to detail to follow business processes correctly, anticipating and understanding the downstream impact and ensuring high quality the first time/every time.
• Effective team player.
• Demonstrates professionalism by consistently acting with respect and courtesy to co-workers and customers, maintains personal credibility, and exhibits excellent teamwork
• Proficiency in Microsoft Office, including Word, Excel and Outlook.
• Able to prioritize and work well under pressure.

Please forward resume to [email protected]  

Underwriting Specialist – Property and Casualty – Toronto

The Underwriting Specialist is responsible for underwriting and servicing increasingly complex accounts in accordance with established guidelines and business objectives in the achievement of national standards for data quality and service levels.

Comma Recruitment are looking for a Senior Underwriter / Underwriting Specialist with 5+ years progressive experience in Commercial Underwriting.

You will be expected to solve complex problems by applying a broad perspective to identify solutions and also in interpreting internal and external business issues and recommending best practices.

RESPONSIBILITIES

Underwriting:

• Implement renewal rate and exposure, retention, and rate adequacy guidelines.
• Responsible for the successful evaluation, documentation, selection, negotiation, and pricing for assigned policies in order to ensure a profitable book of business within established underwriting authority
• Refer and redirect requests for pricing decision and risk selection for risks beyond personal authority, along with recommendations.
• Ensure endorsements, renewals, reissues, and cancellations are reviewed and analyzed in accordance with standards and guidelines.
• Analyze new business for risk profitability by assessing exposures and hazards as determined by review of underwriting data and referring as required.
• Monitor trends and developments identifying areas of concern regarding loss ratios, risk trends, or other discrepancies.
• Assist in the price monitoring, risk selection and data quality performance reviews.
• Understand and apply best business practices towards compliance, internal control and operational risk controls in accordance to national standards and regulatory standards and policies.
• Participate in audits as required.
• Maintain working knowledge of all Information Systems/Programs within underwriting, and analyze/recommend improvements to work processes and procedures.
• Identifies, investigates, and develops new business/expansion opportunities for assigned segment.
• Evaluates, selects and establishes/negotiates proper rate and levels for risks in order to ensure a profitable book of business within established underwriting guidelines.
• Develop and maintain a knowledge and understanding of company operations and procedures.

Sales/Negotiations:

• Develop and maintain a professional relationship with brokers and/or customers to enhance understanding of the target market and to contribute to quality service, problem solving, and risk selection.
• Collaborate with brokers and customers to assist in business retention and customer satisfaction through regular interactions.
• Investigate customers’ risk factors relative to corporate pricing approach to gain support, agreement and enhance relationships.
• Participate in the communication and education of brokers concerning the corporate underwriting philosophy, policies, and procedures as required.
•  Maintain knowledge of industry trends, developments, and regulatory changes
• Provide quality customer service to assigned brokers including clarification of coverage, wordings, and claims history.
• Understand and adhere to service standards in accordance with company guidelines.
• Forge new business relationships and solicit new business opportunities.

Coaching/Mentoring:

• Mentor and train less experienced underwriters and support staff.
• Provide support staff with clear instructions and explanations for data entry to ensure accuracy and service standards are maintained.
• Support the completion of peer file reviews and audits.
• Act as a resource on risks outside of the authority level for less experienced Underwriters, and authorize risks within own established authority levels.
• Provide training, development, and technical guidance to colleagues regarding products, systems, and processes as required.

Operational Leadership:

• Provide input to their Manager/Division Head and/or Corporate Underwriting on various underwriting, strategic, staffing and other issues as requested.
• Assist in developing Underwriting guidelines and procedures.
• Work collaboratively on special projects and assignments when required.

 

QUALIFICATIONS

• Post-secondary school education and/or equivalent on the job experience.
• Completion of the CIP and/or FCIP designation.
• Minimum 5-7 years’ experience in the property and casualty industry
• Working knowledge of underwriting philosophy, policy contracts, rating programs, risk information sources, underwriting/technical manual information, statuary constraints, and computer workflow procedures.
• Ability to work within and adapt to PC oriented environments, including familiarity with e-mail and Internet skills. Working knowledge of Microsoft Office.
• Sound knowledge and understanding of underwriting discipline and pricing models.

Please forward resume to [email protected]

Underwriting Specialist – Commercial Lines $75-85k

Underwriting Specialist – Commercial Lines

Responsible for:

• Successfully achieving corporate underwriting goals.
• The profitable growth of Commercial Lines department by accepting acceptable risks with acceptable conditions at adequate pricing levels.
• Managing the training requirements of the commercial department.
• Ensuring that audits are completed as per the audit guidelines and submitting an audit report to AVP Commercial.
• Ensuring department adheres to corporate underwriting standards, reinsurance treaty restrictions, limit capacity and Insurance Act regulations.
• Assist or develop new product lines of business including appropriate wordings, underwriting rules and rates.
• Provide required KPI reports
• Evaluate ‘program’ opportunities, recommend appropriate action plan and develop/manage all programs as directed by management.
• Collect and analyze competitor technical information and data and recommend any appropriate product changes or realignment of risk appetite.
• Ensure the commercial intra-net site has updated wordings, manuals, rates, marketing material etc.
• Working as a team player and leading by example, both within the department and with other departments for the overall success of the company.

Key Activities:

• Work with the commercial underwriting staff to successfully underwrite and price accounts to achieve profitable growth.
• Implement the corporate goals that have been established.
• Review the key management reports to determine what corporate goals are working effectively and what goals are not and submit a recommended action plan to AVP commercial.
• Implement the established corporate strategies in order to achieve our corporate goals.
• Use in-depth product and market knowledge to successfully underwrite and price accounts for profit and growth.
• Implement the new products or services that have been developed to successfully meet the needs of our customers.
• Technical responsibility for establishing line limits, ensuring appropriate capacity to support product development.
• Identify business opportunities including what competitive product offerings are required to remain competitive in the market place.
• Complete underwriting audits as per the audit guidelines.
• Conduct training secessions.
• Act as a technical resource for underwriting, claims, brokers, IT and management for the intent and interpretations of relevant legislation, wordings and corporate guidelines.
• Work with the Technical Committee to develop system improvements and underwriting guidelines that benefit and can be used throughout.

Experience Required

• In depth technical knowledge and experience and the ability to apply that knowledge in order to work with managers and staff including other departments to achieve corporate goals.
• In depth knowledge of underwriting principles and practices, concepts and methodologies and how they are applied for the successful achievement of corporate goals.
• In depth knowledge of commercial rates and pricing to effectively underwrite the types of business written.
• Effective oral and written communications skills.
• Effective IT skills to effectively manage corporate systems such as: IIS, OPUS, Word, Excel, PowerPoint and Outlook.
• Excellent customer service and business skills.
• Excellent coaching and mentoring skills.
• Excellent presentation skills.

Education and Experience:

• University / College degree, CIP or CRM designation or working towards.
• 8+ years underwriting experience, management /leadership experience a great asset.

Please forward resume to [email protected]

Clinical Quality Control Editor – East GTA $50,000

Clinical Quality Control Editor

Comma Recruitment are currently looking for a Clinical Quality Control Editor, who is flexible to work in all aspects of our quality assurance process. You will be responsible for clinical coordination of files and the final stage clinical report editing.

A medical background or qualification in Kinesiology with editing and medical reporting experience

Qualifications:

• Licensed Regulated Healthcare Practitioner in good standing with your regulatory college or related experience in Healthcare, Qualification in Kinesiology or a medical background
• Knowledge of the independent medical examination process
• Advanced experience in clinical editing and proof-reading to produce defensible, evidence based, objective and impartial medical reports
• Knowledge of applicable legislation on a national platform
• Attention to detail
• Superior organizational and time management skills
• Ability to work under pressure
• Excellent command of the English language, in both written and oral forms
• Superior knowledge of medical terminology and the scope of practice of different disciplines
• Working knowledge of Microsoft Windows

Please forward resume to [email protected]   

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