For companies:
For professionals:
For everyone:
For developers:
Responsibilities
• Evaluate and estimate damages in the desk adjustment of claims
• Coordinate and manage vendor engagement on assigned cases
• Analyze FNOL reports and promptly contact Members
• Efficiently investigate claims, evaluate contract language and identify appropriate coverage where applicable
• Diligently manage file diaries that move claims toward a timely resolution
• Identify and pursue recovery opportunities
• Adhere to all statutory, regulatory and compliance fair claims practices
• Identify and report potentially fraudulent claims
• Develop and maintain effective business relationships with internal and external partners
• Serve as a technical resource to peers and Member Care associates
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