Claims Investigation Specialist
About the role
Permanent Full Time
Are you curious, bring a unique perspective and have an investigative mind? Want to be part of a National team whose goal is identifying and investigating suspicious and fraudulent disability claims?
We are looking for a Claims Investigation Specialist to join our Claims Investigation Unit.
Through collaboration with case managers and our stakeholders, you will investigate suspicious claims to identify potential misuse of benefits and fraud aiming to reduce claim duration.
WHAT YOU WILL DO:
- Consult with the Disability Management Services offices to identify and investigate suspicious claims and provide direction and support to ensure an efficient and effective investigation is completed
- Conduct Open-Source Investigations
- Determine whether surveillance is necessary to the investigation, and manage surveillance through our external vendor
- Conduct interviews with plan members/sponsors, tipsters, physicians, and other stakeholders
- Manage overpayment recoveries by negotiating repayment agreements with plan members when fraudulent activity is identified
- Collaborate with the Corporate Security and Investigation team and Legal Department when fraudulent claims are identified and assist in loss recovery via the criminal and civil process
- Create and maintain reference and training material for the field
- Develop and maintain reporting to enhance our ability to track the success of our fraud management program.
WHAT YOU WILL BRING:
-
5+ years of disability case management experience (ideally – open to less) and extensive knowledge of disability insurance
-
Knowledge of various medical conditions, expected functional impacts, and standard treatment protocols
-
Strong organizational (documentation + reporting) and time-management skills to handle multiple simultaneous investigations
-
Bachelor's degree or college diploma in relevant discipline
-
Strong decision-making, problem solving, and analytical skills
-
Exceptional written and verbal communication skills that include:
-
Ability to negotiate with internal and external stakeholders
-
Ability to engage in a positive manner
-
Excellent customer service
-
As this position is posted in several locations, we specify that bilingualism is an asset (fluent in French and English) but is required for Quebec only as the position will regularly serve our clients with French and English-speaking needs.
-
Reliability Status security clearance - this is a personnel security status that is required before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website
The base salary for this position is between $52,800.00 - $97,700.00 annually. This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc). If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.
Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.
Be your best at Canada Life- Apply today!
Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.
You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.
Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.
Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations.
We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Canada Life policies. To request a reasonable accommodation in the application process, contact talentacquisitioncanada@canadalife.com.
Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted.
About Canada Life
At Canada Life, we’re focused on improving the financial, physical and mental well-being of Canadians. Whether handling policy claims, help growing and protecting clients’ retirement and investment savings, providing workplace mental health support for all employers or helping build stronger communities by investing in community projects, we are committed to putting the customer first in all that we do.
That trust is built on the dedication, skill and energy of our employees and advisors and their commitment to our customers and to our communities.
Canada Life is a subsidiary of Great-West Lifeco Inc. and is a member of the Power Corporation group of companies.
Claims Investigation Specialist
About the role
Permanent Full Time
Are you curious, bring a unique perspective and have an investigative mind? Want to be part of a National team whose goal is identifying and investigating suspicious and fraudulent disability claims?
We are looking for a Claims Investigation Specialist to join our Claims Investigation Unit.
Through collaboration with case managers and our stakeholders, you will investigate suspicious claims to identify potential misuse of benefits and fraud aiming to reduce claim duration.
WHAT YOU WILL DO:
- Consult with the Disability Management Services offices to identify and investigate suspicious claims and provide direction and support to ensure an efficient and effective investigation is completed
- Conduct Open-Source Investigations
- Determine whether surveillance is necessary to the investigation, and manage surveillance through our external vendor
- Conduct interviews with plan members/sponsors, tipsters, physicians, and other stakeholders
- Manage overpayment recoveries by negotiating repayment agreements with plan members when fraudulent activity is identified
- Collaborate with the Corporate Security and Investigation team and Legal Department when fraudulent claims are identified and assist in loss recovery via the criminal and civil process
- Create and maintain reference and training material for the field
- Develop and maintain reporting to enhance our ability to track the success of our fraud management program.
WHAT YOU WILL BRING:
-
5+ years of disability case management experience (ideally – open to less) and extensive knowledge of disability insurance
-
Knowledge of various medical conditions, expected functional impacts, and standard treatment protocols
-
Strong organizational (documentation + reporting) and time-management skills to handle multiple simultaneous investigations
-
Bachelor's degree or college diploma in relevant discipline
-
Strong decision-making, problem solving, and analytical skills
-
Exceptional written and verbal communication skills that include:
-
Ability to negotiate with internal and external stakeholders
-
Ability to engage in a positive manner
-
Excellent customer service
-
As this position is posted in several locations, we specify that bilingualism is an asset (fluent in French and English) but is required for Quebec only as the position will regularly serve our clients with French and English-speaking needs.
-
Reliability Status security clearance - this is a personnel security status that is required before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website
The base salary for this position is between $52,800.00 - $97,700.00 annually. This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc). If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.
Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.
Be your best at Canada Life- Apply today!
Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.
You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.
Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.
Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations.
We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Canada Life policies. To request a reasonable accommodation in the application process, contact talentacquisitioncanada@canadalife.com.
Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted.
About Canada Life
At Canada Life, we’re focused on improving the financial, physical and mental well-being of Canadians. Whether handling policy claims, help growing and protecting clients’ retirement and investment savings, providing workplace mental health support for all employers or helping build stronger communities by investing in community projects, we are committed to putting the customer first in all that we do.
That trust is built on the dedication, skill and energy of our employees and advisors and their commitment to our customers and to our communities.
Canada Life is a subsidiary of Great-West Lifeco Inc. and is a member of the Power Corporation group of companies.