Role Overview

We are seeking an experienced Life Insurance Claims Specialist with strong expertise in Life Insurance and Living Benefits Claims administration to support Canadian insurance operations. The ideal candidate will have extensive experience handling end-to-end claims processing, excellent client servicing capabilities, and fluency in both French and English . This role requires close collaboration with onshore stakeholders, clients, and internal teams to ensure accurate and timely resolution of claims while maintaining high service standards and regulatory compliance.

Key Responsibilities

- Process and adjudicate Life Insurance and Living Perks Claims for Canadian policyholders in accordance with company guidelines, service-level agreements (SLAs), and regulatory requirements.
- Review claim documentation, validate policy provisions, assess eligibility, and determine claim outcomes with accuracy and attention to detail.
- Coordinate with onshore teams, business partners, and clients to resolve claim-related queries and ensure seamless transaction processing.
- Manage claim cases from initiation through closure, ensuring all required documentation is collected, reviewed, and maintained.
- Identify missing information and proactively follow up with customers, beneficiaries, healthcare providers, or internal stakeholders to facilitate claim completion.
- Maintain accurate records and update claims management systems with all relevant activities and decisions.
- Monitor claim turnaround times and ensure adherence to quality standards and operational KPIs.
- Support investigations and escalation management for complex or exceptional claim scenarios.
- Participate in process improvement initiatives aimed at enhancing operational efficiency, customer experience, and quality outcomes.
- Ensure compliance with Canadian insurance regulations, internal policies, and data privacy requirements.
- Collaborate with quality, training,



and operations teams to drive continuous process improvement and operational excellence.

Required Skills Qualifications
- Minimum 6 7 years of experience in Life Insurance and/or Living Benefits Claims Processing .
- Strong understanding of insurance products, policy administration, claims adjudication, and customer servicing.
- Fluent French language proficiency (spoken and written) is mandatory.
- Excellent verbal and written communication skills in English .
- Ability to interact professionally with clients, stakeholders, and cross-functional teams across geographies.
- Experience working with Canadian Life Insurance processes will be highly preferred.
- Strong analytical and decision-making skills with the ability to interpret policy terms and claim documentation.
- High attention to detail and commitment to quality and accuracy.
- Proficiency in claims processing systems, Microsoft Office applications, and workflow management tools.
- Ability to manage multiple priorities while meeting established deadlines and service standards.

Preferred Attributes
- Customer-centric mindset with strong problem-solving capabilities.
- Ability to work independently while collaborating effectively within global teams.
- Experience handling sensitive customer information with professionalism and confidentiality.
- Strong organizational and time-management skills.
- Adaptability to a dynamic operational environment and willingness to participate in process transformation initiatives.

Work Workplace
- Willingness to work in night shifts aligned with Canadian business hours.
- Ability to work effectively in a fast-paced, performance-driven environment.
- Commitment to delivering exceptional customer service and maintaining operational excellence.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

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