The Claim Investigator is responsible for ensuring that all claims are assessed and processed accurately in accordance with policy terms and conditions, company guidelines, and regulatory requirements. This includes reviewing claim documents, validating claim eligibility, identifying discrepancies or potential risks, and ensuring fair and consistent claim decisions while maintaining service quality and turnaround time standards.
Also ensures compliance with established Standard Operating Procedures (SOP), audit requirements, and internal control frameworks. Working closely with Claims, Operations, Risk, and Compliance teams, the incumbent supports continuous process improvement, monitors claim quality standards, and helps strengthen governance by ensuring claim handling practices align with both internal policies and external regulatory expectations.
Position Responsibilities
- Conduct performance evaluations and implement strategies to improve team efficiency
- Identify trends in claims and implement strategies to address potential fraud or areas needing improvement.
- Communicate effectively with internal stakeholders like claims adjusters, underwriters, and legal teams.
- Foster collaboration between investigators, promoting knowledge sharing and teamwork
- Report suspicious activity to the appropriate authorities and cooperate with investigations
- Compile reports on team performance, investigation outcomes, and identified trends.
Required Qualifications
- Bachelor's degree in business, law, criminal justice, or a related field with a minimum of 4 years of experience in claims investigation.
- Proven leadership experience in managing and motivating a team.
- In-depth knowledge of insurance claim investigation practices and procedures.
- Excellent analytical and problem-solving skills.
- Strong communication and interpersonal skills.
Preferred Qualifications
- Strong communication, coordination, and stakeholder management skills
When you join our team:
- We’ll empower you to learn and grow the career you want.
- We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
- As part of our global team, we’ll support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.
Manulife is an Equal Opportunity Employer
At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.
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 Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact hr@manulife.com.
Hybrid