Bilingual Life& Health Claim Specialist role (French & English)

Work Location:

Hours:

Line of Business:

Pay Details:

TD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compensation policies and practices have been designed to allow colleagues to progress through the salary range over time as they progress in their role. The base pay actually offered may vary based upon the candidates skills and experience job-related knowledge geographic location and other specific business and organizational needs.

As a candidate you are encouraged to ask compensation related questions and have an open dialogue with your recruiter who can provide you more specific details for this role.

Job Description:

TD Insurance is part of TD Bank Financial Group one of Canadas largest financial institutions. TD Insurance helps protect clients from the accidents of life with a wide range of products including credit protection life health travel home and auto insurance. With more than three million clients TD Insurance authorized products and services are available online over the phone and through a network of more than 1000 TD Canada Trust branches.

In Canada we have two lines of business: General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada.

At TD Insurance we are committed to fostering an inclusive accessible environment. With a Canada-wide workforce of over 5000 employees and offices in Atlantic Canada Quebec Ontario and Alberta our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent isappreciatedand professional development is taken seriously. More than just a job we offer rewarding careers.

Department Overview

The Claims Departmentis responsible foradjudicatingLife Critical Illness Accidental Death and Dismemberment travel Disability and Hospital claims for the Banks Credit Protections programs and TD Lifes Direct Life and Health programs. Adjudication of these claims involves daily empathetic and professional communication with customers who are going through a personal crisis either due to significant disability or death of a spouse or a family member. This departmentis responsible forevaluation of medical diagnoses and the impact of disability on their ability to work at gainful employment.

Job Details

The position requiresa high levelof technicalexpertisethat encompasses claim adjudication principles and a strong knowledge of insurance products as well as all insurance certificates administered and insured by TD involves exceptional verbal and written communication with customers that are going through a personal crisis. Professionalism empathy sensitivity and respect are essential throughout the adjudication process.

Accountabilities

• Ensure claim philosophy for TD Life and Health is administered in a consistent and cost-effective mannerin accordance withTPA and vendor agreements.

• Co-ordinate litigation activity with external counsel and TDBFG legal department including reviewing pleadings statements of claim and defense.

• Represent TD Life on litigation claim matters including attending some examinations for discovery mediation and trials.

• Support creating documenting and implementing training and procedure manuals.

• Provide leadership motivate mentor and develop staff in all areas of claim adjudication.

• Provide thorough analysis and clear and concise recommendations on claims referred based on authority limits and contractual provisions.

• Approve and decline claims over the Claim Advisors and vendor limits.

• Provide problem and complaint resolution on contentious claims for issues not resolved by Advisors and vendors; coordinate responses to claim appeals including issues from all sources such as the Ombudsman and regulatory bodies.

• Monitor workflow and reports to ensure all claim service level agreements are met.

• Conduct Quality Assessment Reviews (QARs) for the vendor and provide feedback and recommendations based on the results.

• Provide backup to the Claims Management team asrequired.

• Collaborate with other leaders in TDI to ensure all claim functions are aligned with the goals andobjectivesof the organization.

• Approve largelossclaims and provide feedback to the vendor on case management.

Job Requirements

• Bilingual French and Englishisrequired

• MinimumGrade 12 education plus 5 years relevant insurance experience in either Individual or Group claims or University degree or RN qualification.

• Through ongoing professional development the Claims Specialist is required to be actively working towards FLMI ALHC or FLHC designations.

• Solid working knowledge of Word and Excel.

• Solid knowledge of TD Life products.

• Superior interpersonal skills and ability to handle stressful situations with tact and courtesy.

• Must be able to contribute to a positive working environment and adapt effectively to a changing environment.

• Utilize Change Management skills to promote and implement change positively working as part of a team to accomplish the goals of our department.

Who We Are:

TD is one of the worlds leading global financial institutions and is the fifth largest bank in North America by branches/stores. Every day we strive to make every interaction product and experience remarkably human and refreshingly simple for over 27 million households and businesses in Canada the United States and around the world. More than 95000 TD colleagues bring their skills talent and creativity to foster deeper relationships ensure disciplined execution and build a simpler faster banking experience. TD is deeply committed to being a leader in client experience that is why we believe that all colleagues no matter where they work are client facing. Together we are reimagining what banking can be for our clients colleagues and communities.

Our Total Rewards Package
Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial physical and mental well-being goals. Total Rewards at TD includes a base salary variable compensation and several other key plans such as health and well-being benefits savings and retirement programs paid time off banking benefits and discounts career development and reward and recognition programs. Learn more

Additional Information:
Were delighted that youre considering building a career with TD. Through regular development conversations training programs and a competitive benefits plan were committed to providing the support our colleagues need to thrive both at work and at home.

Please be advised that this job opportunity is subject to provincial regulation for employment purposes. It is imperative to acknowledge that each province or territory within the jurisdiction of Canada may have its own set of regulations requirements.

Colleague Development

If youre interested in a specific career path or are looking to build certain skills we want to help you succeed. Youll have regular career development and performance conversations with your manager as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities.

If youre passionate about helping clients and building deep lasting relationships TD offers diverse career paths where you can grow your expertise and make a meaningful impact.

Were committed to your success and foster a respectful workplace where diverse perspectives are valued everyone has fair opportunities to grow and you can unlock your full potential to achieve your career goals. Here at TD we hire and develop the best.

Training & Onboarding
We will provide training and onboarding sessions to ensure that youve got everything you need to succeed in your new role.

Interview Process
Well reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call.

Accommodation
Your accessibility is important to us. Please let us know if youd like accommodations (including accessible meeting rooms captioning for virtual interviews etc.) to help us remove barriers so that you can participate throughout the interview process.

We look forward to hearing from you!

Language Requirement (Quebec only):