Fraud Claims Operations Representative Jobs in Edmonton, AB

Our employees are at the heart of everything we do. Together, we help people, businesses, and society prosper in good times and be resilient in bad times.

Our employee promise represents Intact's commitment to you in exchange for living our Values, striving to do your best work, being open to change and investing in your career. In return, we promise to provide support, opportunities and performance-led financial rewards at a workplace where you can shape the future, win as a team and grow with us.

Pay at Intact is about much more than just salary.

• Flexible work arrangements and a hybrid work model

• Possibility to purchase up to 5 extra days off per year

• Multiple benefits offered to support physical and mental wellbeing, including telemedicine, Wellness account and much more

• Share plan & other savings: up to 12% of salary or even more (ask how you could earn guaranteed income for life)

Salary range (but not limited to):

Annual bonus target, based on the base salary, with a potential payout of up to double the target (subject to personal and company performance):

As part of our commitment to Win As A Team, we share our success with employees through our annual bonus plan and Employee Share Purchase Plan (ESPP) - with Intact matching 50% of your net shares.

Our pension offerings provide flexibility and long-term security for our employees beyond their careers. We are one of the few companies offering the opportunity to receive guaranteed income for life via our defined benefit pension plan.

Salary for the candidate will be determined taking into consideration a number of factors including: experience, skills, qualifications, anticipated contribution to role, internal equity, etc. The salary range presented above is based on a 35-hour workweek and would represent a majority of different candidate profiles. However, we encourage candidates who may fall outside of this range to apply as well.

About the role

We're seeking an Accident Benefits Claims Specialistto join our growing team in a full-time, permanentcapacity, based in Edmonton or Calgary.

In this role, you'll deliver high-quality service while investigating, evaluating, negotiating, and resolving complex Accident Benefits claims in compliance with corporate policies, provincial legislation, and regulatory standards. You'll also play an important role in supporting our operational readiness as we transition toward the upcomingCare-Firstauto reform environment.

What you'll do here:

• Investigate and manage complex Accident Benefits claims arising from automobile losses.
• Assess entitlement, exposure, and reserving requirements in alignment with Alberta legislation and company guidelines.
• Manage claims with out-of-province exposures, coordinating benefits appropriately across jurisdictions.
• Communicate with claimants, legal counsel, medical professionals, rehabilitation providers, vendors, and internal stakeholders throughout the claim lifecycle.
• Review and analyze medical records, treatment plans, assessments, and financial documentation to support claim decisions.
• Negotiate fair and timely settlements, resolving claims within delegated authority.
• Coordinate independent medical examinations (IMEs), rehabilitation services, and vendor support as required.
• Maintain accurate, timely file documentation, including reserves, file strategy, and activity notes.
• Contribute to process improvements and support operational change initiatives related to Care-First reforms.
• Provide technical guidance, coaching, training, and mentorship to junior colleagues and team members.
• Partner effectively with internal teams (e.g., Legal, Underwriting, and other departments) to support sound claim outcomes.
• Deliver exceptional customer service while navigating sensitive and complex situations with professionalism and empathy.

What you bring to the table:

• 5-7+ years of insurance experience, including Accident Benefits claims handling within the P&C insurance industry.
• Strong technical knowledgeof Accident Benefits claims practices, including investigation, evaluation, negotiation, and resolution.
• Experience managing complex and litigated Accident Benefits claims.
• Working knowledge of out-of-province claims handling and inter-jurisdictional coordination.
• Solid understanding of Alberta auto insurance legislation and evolving reforms, including preparedness for the Care-First model.
• Excellent negotiation, analytical, and decision-making skills.
• Strong written and verbal communication skills, with the ability to manage difficult conversations confidently and professionally.
• Proven ability to prioritize and manage a high-volume caseload in a fast-paced environment.
• Proficiency with claims management systems and Microsoft Office.
• CIP designation(or actively working toward completion) is an asset.

Preferred qualifications:

• Experience coaching, mentoring, and developing junior claims professionals.
• Knowledge of rehabilitation practices and medical terminology.
• Ability to work independently while contributing positively to a collaborative team culture.
• Demonstrated commitment to customer service excellence and continuous improvement.

The posting will close September 1st at 11:59PM

#LI-Hybrid

We are an equal opportunity employer

At Intact, our Value of respect is founded on seeing diversity as a strength. We strive to create an accessible workplace where employees feel valued, included and encouraged to share their unique perspectives.

We encourage applications from individuals who are members of equity-deserving groups, including but not limited to women, Indigenous peoples, persons with disabilities, Black people, and members of the 2SLGBTQI+ community.

As part of Intact's commitment to reconciliation, we acknowledge that we work, meet and travel across the land currently called Canada, originally inhabited by First Nations, Metis and Inuit people. This history extends through many centuries and continues to evolve today.

We have policies to ensure equal access and participation for people with disabilities, including providing workplace adjustments (accommodations). A copy of applicable policies is available on request.

If we can provide a specific adjustment to make the recruitment process more accessible for you, please let us know when we reach out about a job opportunity. We'll work with you to meet your needs.

Learn more about our recruitment process and your candidate journey here.

Please note that Intact does not provide sponsorship or other support for immigration-related matters including but not limited to employer-specific closed work permits. Candidates must be eligible to work in Canada from the anticipated start date and throughout their employment and are solely responsible for maintaining their work eligibility.

If you are an employee of Intact or belairdirect, please apply for this role on Internal Career Site.