Life and Living Benefits Claims Adjudicator

Who We Are

At Disability Management Institute (DMI), we deliver innovative, end-to-end disability and absence management solutions that transform how employers support their teams. Since 2002, our experienced team of dedicated professionals have combined deep expertise with genuine care to create partnerships that benefit employees, employers, and stakeholders alike.

Our culture thrives on connection, collaboration, and respect. Open communication, team bonding, and a spirit of appreciation create an environment where you feel supported, valued, and empowered to bring your authentic self to work every day.

The Opportunity The Life and Living Benefits Claims Adjudicator will adjudicate Critical Illness, Accident and Serious Illness, Life, and Accidental Death and Dismemberment claims within established timeframes and within the scope of the policy, while ensuring excellent customer service. The Life and Living Benefits Claims Adjudicator will manage a caseload of new and ongoing claims, apply the appropriate policy provisions to render decisions, and keep claimants, beneficiaries, executors, and other stakeholders informed at every stage of the claim.

This is a remote role within Canada. We are open to candidates across the country, however you must work within our core business hours.

What You’ll Be Doing

• Manage a caseload of new and ongoing Life and Living Benefit claims, ensuring service standards are met
• Interview claimants, beneficiaries, and employers to gather relevant claim information
• Process all claims in date order, in accordance with the agreed upon service standards for each client
• Assess claims for contractual eligibility, determine which plan provisions apply, and investigate accordingly
• Use available resources to assess medical information and policy, liaising professionally with insurance agencies, doctors, employees, management, lawyers, and other parties as needed
• Apply the appropriate policy provisions when reviewing claims and render a decision
• Provide proactive communication to claimants, beneficiaries, executors, legal representatives, and other stakeholders on claim status and progression
• Draft and deliver written correspondence outlining claim activity and next steps
• Calculate and pay approved claims
• Maintain confidentiality of client and corporate records and medical claims information

What You Bring to the Team

• Minimum 5 years of claims experience in a group insurance environment
• Minimum 2 years of experience adjudicating Life and Living Benefit claims, including Critical Illness, Accident and Serious Illness, Life, and Accidental Death and Dismemberment
• Post-secondary degree or diploma, or equivalent experience
• Familiarity with medical terminology and Life insurance contract language, specifically surrounding Life and Living Benefits products
• Strong MS Office skills, with particular strength in Excel reporting
• CEBS, CIP, or LOMA designation is an asset
• Medical background is an asset

Critical Competencies

TO BE CONFIRMED

Compensation At the time of this posting, the estimated annual base salary for this position is $68,000 - $75,000. Individual compensation within this range is determined by factors such as job-related skills, relevant experience, and education/training. This range reflects the annual base salary only and does not encompass the comprehensive total rewards package that we proudly offer.

Why DMI is the Place for You

• Beyond salary, we offer generous paid time off including 3 weeks minimum vacation, plus 26 long weekends a year through our much-loved Happy Friday program to help you balance life and work on your terms
• We provide flexible work options including remote and hybrid schedules, extended health and dental benefits, RRSP matching, and wellness support, including comprehensive mental health resources
• Clear career paths, personalized learning, and leadership committed to invest in your development

Belonging Starts Here Diversity, inclusion, and belonging aren’t just programs at DMI; they are our foundation. We foster a safe, respectful, and inclusive workplace where everyone belongs and can thrive.

If you need accommodation during any stage of the hiring process, please let us know! We’re here to help.

If you’re ready to do meaningful work and grow your career with DMI, we’d love to hear from you. Click Apply to submit your application.

5+ years group insurance claims experience, 2+ years adjudicating Life and Living Benefits claims, post-secondary degree or diploma or equivalent, MS Office skills with Excel reporting, familiarity with medical terminology and life insurance contract language.

Key Responsibilities

• adjudicating claims
• interviewing claimants
• processing claims

Skills & Tools

Microsoft Office, Microsoft Excel

Job Details

• Category: Healthcare Services - Allied Health
• Seniority: Senior Level
• Commitment: Full Time
• Workplace: Remote — Canada
• Salary: CAD 68,000 – 75,000 / year
• Languages: English

Benefits

• 401k matching
• Generous paid time off
• Retirement plan

About Disability Management Institute

A provider of disability and absence management solutions for employers. — Industry: Healthcare