STD Claims Examiner II making accurate claim decisions for Short Term Disability claims. Collaborating with team members in a hybrid work environment from South Portland, ME.
About the role
- Fraud Triage Specialist responsible for identifying fraud indicators in insurance claims. Analyzing information and collaborating with investigative teams within the Claims department.
Responsibilities
- Identify fraud indicators in insurance claims by collecting and analyzing information to determine if further investigation is required for assignment to our Inside Investigation Team.
- Utilize fraud analytic tools to review leads and determine viability of information
- Participate and/or manage project work, by working with members of the Investigative Services and other Claims departments to deliver on project goals
- Communicate in a timely and respectful manner with stakeholders (internal and external) when making decisions and/or providing feedback on leads, tips, and projects
- Consult with internal and external stakeholders to improve fraud identification strategies, financial tracking, and support business initiatives
- Innovate investigative strategy and support artificial intelligence initiatives for claims (all lines of business)
Requirements
- A minimum of 2 years claims experience in either auto, accident benefits, property, or casualty
- Knowledge of provincial legislation governing auto insurance
- Strong analytical and decision-making skills
- Strong communication and time management skills
- Excellent written and verbal communication skills
- A friendly and can-do attitude
- University degree or college diploma and/or equivalent business experience
- Completed, or are working toward, Chartered Insurance Professional (CIP) designation
- Strong data analysis skills, creative thinking skills
- Ability to identify fraud indicators and innovate investigation strategy
- Familiarity with Artificial Intelligence initiatives and practical applications
- Additional claims experience (in a different line of business: auto, property, accident benefits, casualty)
- Additional investigation experience in the insurance and/or financial industry
- Bilingualism in English and French is an asset
Benefits
- Flexible work arrangements and a hybrid work model
- Possibility to purchase up to 5 extra days off per year
- Multiple benefits offered to support physical and mental wellbeing, including telemedicine, Wellness account and much more
- Share plan & other savings: up to 12% of salary or even more
- Annual bonus target, based on the base salary, with a potential payout of up to double the target (subject to personal and company performance): 5%
- Pension offerings providing flexibility and long-term security for employees
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