Claims Advisor - Healthcare Investigations

Individually we are people, but together we are Aviva. Individually these are just words, but together they are our Values – Care, Commitment, Community, and Confidence.

Aviva has an excellent opportunity in our Oakville office. We are recruiting for a Claims Advisor on our Healthcare Investigations team to help protect our Customers Limits within Accident Benefits.

As a Healthcare Investigator within the Accident Benefits claims team, you will be responsible for managing claims related to Healthcare investigations. Your role will involve identifying and mitigating suspicious activities, ensuring medical clinics and providers are aligned with College/FSRA regulations, and supporting the Healthcare department's mission to Educate, Protect, and Pay. You will work closely with various stakeholders to safeguard the integrity of the claims process and provide valuable insights to prevent future fraud.

Come join our team!

What You'll do

• Investigate motor vehicle accident injury claims with a focus on identifying potential fraud.
• Determine policy coverage and adjust financial reserves in compliance with the Statutory Accident Benefits Schedule (SABS).
• Provide excellent customer service by focusing on customer demands, communicating clearly, and actively handling claims to closure.
• Provide mentoring to Healthcare Service Advisors to strengthen and improve their skills in handling claims investigations.
• Gather information at its earliest stage from customers, health practitioners, employers, police, plaintiff lawyers, accountants, other insurers, witnesses, etc.
• Make fair and reasonable decisions by considering all information, consulting resources, and applying expertise when required.
• Utilize data analytics and fraud detection tools to identify suspicious claims and patterns.
• Actively participate in mentoring and training sessions and collaborate with team members.
• Take an active role in creating an environment of continuous improvement.
• Assume handling of files that fit within the required scope of Healthcare Investigations
• Identify opportunities and act on protecting customers limits and improving the customer experience through time spent in the work and with the use of data
  
  

What You'll Bring

• University degree or equivalent experience or college diploma is preferred
• 2+ years of Accident Benefits adjusting experience is an asset
• Excellent customer service, mentor and communication skills
• Ability to adapt and work with various computer programs, databases and software
• CIP designation or working towards designation preferred
  
  

What You’ll Get

• The salary band for this position ranges from $54,500 to $101,100. Please note that individual salary is determined by factors such as job-related knowledge, skills and experience, as well as internal equity.
• Compelling rewards package including base compensation, eligibility for annual bonus, retirement savings, share plan, health benefits, personal wellness, and volunteer opportunities.
• Outstanding Career Development opportunities.
• We’ll support your professional development education.
• Competitive vacation package with the option to purchase 5 extra days off per year
• Employee driven programs focused on gender, LGBTQ+, origins, diversity and inclusion
• Corporate wellness programs to support our employees’ physical and mental health
• Hybrid flexible work model
  
  

Please note that we may use AI tools to help us through the recruitment process. This is an existing position which has been posted both internally & externally.

Aviva Canada has an accommodation process in place to provide accommodations for employees with disabilities. If upon commencement of employment you require a specific accommodation because of a disability, please contact your Talent Acquisition Partner so that an appropriate accommodation can be arranged. This process applies throughout your career with Aviva Canada.