Group Claims Service Specialist

POSITION: Group Claims Service Specialist

LOCATION: La Capitale Civil Service Insurer

DEPARTMENT: Group Claims

REPORTS TO: Director, Group Claims

STATUS: Permanent


La Capitale Civil Service Insurer is committed to providing a diverse, inclusive work environment free of all forms of discrimination, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in pursuing a job opportunity with La Capitale Civil Service Insurer and require us to make any accommodations, please advise us so that we can work with you to make suitable accommodations in the recruitment and selection process.


This role is primarily responsible for working directly with clients and working with many internal resources and departments to coordinate our services and improve customer satisfaction. The Group administrator service specialist could work with Account Executives, Employer, Client Service Representatives and/or other many internal resources, as well as directly with our client.


  • Respond to client complaints, inquiries & service requests pertaining to their Disability programs and services.
  • Provide staff with support, advice, instructions, approval and resolution to regarding unusual claim.
  • Deal with complex, difficult/unusual inquiries, complaints and situations. Identify, define and take appropriate action to resolve. Ensure that objectivity, tact and clearly written and verbal communications are maintained in highly sensitive situations.
  • Attend client/broker/TPA meetings, as needed.
  • Assist in defining, developing and implementing departmental policies, process and procedures.
  • Responsible for internal reporting and identification of issues.
  • Explain reports to clients in collaboration with the sale team.
  • Responsible for client support, annual planning preparation and meetings where appropriate.
  • Act as a liaison with internal departments to resolve issues that may arise with clients.
  • Collect and analyze data to measure customer service satisfaction and suggest improvements in our process.
  • Follow up on manager consultations.
  • Travel across Canada required.


  • Detail-oriented with strong organizational and time management skills.
  • Ability to perform multiple tasks effectively and concurrently.
  • Demonstrated ability to manage relationships and influence key stakeholders.
  • Demonstrated ability to work effectively under pressure and within a collaborative team-oriented environment using sound judgment in decision-making skills. 
  • Excellent verbal and written communication skills.
  • Strong analytical and presentation skills.
  • Demonstrated strong functional and technical skills and/or the ability to grasp technical concepts quickly.
  • Strong background in Group Disability Insurance.


  • Minimum 5-10 years of complex Claims handling experience required.
  • Preferable work experience in a client interactive Claims capacity role.
  • Strong development, facilitation, and presentation skills preferred.
  • Demonstrated sound knowledge of the Group Insurance industry, Claims, and related client relationship experience preferred.
  • Proficient with the Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
  • Coaching and mentoring background an asset.
  • Ability to be flexible, multi-task and work with limited direction.

Please submit resume and cover letter to (Opens in an email tools)