Job Title

JOB TITLE: CLAIMS SUPPORT SPECIALIST LOCATION: 18 YORK STREET, TORONTO WORKING MODEL: 100% ONSITE TORONTO This is a bilingual position (French/English). Description This position blends technical expertise with emotional intelligence, requiring professionals who can manage sensitive inquiries, process documentation with precision, and engage empathetically with claimants who may face barriers due to trauma, mental health challenges, or poverty. While the nature of the work is emotionally charged, it is also mission-driven, time-sensitive, and results-oriented. Successful candidates will demonstrate strong communication, adaptability, and integrity, balancing empathy with efficiency to deliver high-quality claim resolutions. This is an opportunity to create meaningful impact while maintaining professionalism, discretion, and accountability in all interactions. Deliverables Primary Administrative Duties Managing Correspondence: Handle incoming and outgoing mail, email, faxes, and phone communications. Ensure calls, supports tickets and claims are processed promptly and directed appropriately. Data Entry & Verification: Enter, review, and verify data from electronic and paper forms into a standard database. Maintain accuracy and confidentiality in all input. Document Processing & Organization: Scan, file, and store sensitive materials securely. Organize physical and digital records to ensure efficient retrieval when needed. Claimant Support & Communication Phone Assistance: Answer incoming calls in a professional and empathetic manner, assisting claimants and representatives with inquiries related to their claims and the claims process. Outbound Calls & Follow-ups: Contact class members to obtain necessary documentation, confirmations, or additional details required to process claims efficiently. Claim Status Notifications: Prepare and send notifications regarding claim status, review decisions, and next steps. Ensure information is conveyed clearly and respectfully. Multi-channel Communication: Engage with claimants and representatives through phone, email, fax, and mail to ensure consistent and transparent communication. Ensuring Ethical & Professional Standards Maintaining Compliance: Ensure adherence to company policies, privacy laws, and regulatory requirements when handling claimant information. Delivering High-Quality Work: Maintain precision and attention to detail when processing claims, data, and correspondence. Handling Sensitive Interactions: Approach conversations with claimants and representatives with empathy, patience, and professionalism, recognizing the emotional weight of certain claims, while also meeting expectations of project deliverables and timelines. Call Centre Responsibilities: Respond to incoming calls with empathy, professionalism, and discretion. Provide accurate information about the claims process while strictly adhering to confidentiality protocols. Escalate high-risk or complex cases to appropriate internal channels as needed. Maintain detailed and objective call notes in the system for documentation and audit purposes. Expectations: Emotional resilience in managing difficult conversations, potentially involving traumatic events. Maintain composure, neutrality, and supportive tone at all times. Ability to navigate the conversation to quickly provide an answer/resolution for the call. Adhere to scripting guidelines without sounding roboticbalancing compliance with a human touch. Attending regular debriefings and mental wellness check-ins. Support Tickets Responsibilities: Triage, assign, and resolve client or internal inquiries submitted via ticketing systems. Identify sensitive cases that may require escalation or prioritization. Ensure timely, respectful, and comprehensive responses are logged and tracked. Expectations: Demonstrate discretion and thoughtfulness in written communication. Flag concerning trends or repeated issues to leadership for proactive intervention. Maintain accurate records and follow up on unresolved tickets within set timelines. Attending regular debriefings and mental wellness check-ins. Claims Coding and Claims Quality Checks Responsibilities: Code claim details based on policy documentation, accurately capturing sensitive or traumatic descriptions without alteration or bias. Conduct quality assurance checks to ensure completeness, accuracy, and compliance with internal and regulatory standards. Identify inconsistencies or red flags and raise them for investigation or review. Expectations: Display strong attention to detail and maintain zero tolerance for errors or assumptions. Handle potentially distressing content with professionalism and without personal judgment. Contribute to continuous improvement by providing feedback on coding inconsistencies or process gaps. Maintain psychological safety by taking breaks and utilizing support resources as needed. Attending regular debriefings and mental wellness check-ins.