Job Details

Acts as an advocate for most complex clients and claims, demonstrating advanced problem resolution skills and the ability to manage and communicate issues for key accounts by providing coverage advice to clients. Reviews coverage positions and challenges adjusters as warranted while advocating the best possible outcome for clients in accordance with service standards. Facilitates client meetings, claims reviews and vendor visits. Responsible for negotiating changes in reserves for a positive client outcome, providing status reports to clients as required by any applicable service plan, and reviewing action plans and reserves. Reviews all new problematic or complex claims on designated clients and formulates a plan of action to achieve a favorable claim resolution. About You Required: Bachelor's degree or commensurate experience; 5 years' related experience in claims. Workers' Compensation expertise. Strong knowledge of claim and coverage issues. Excellent written and verbal communicati...Claims, Advocate, Senior, Healthcare, Benefits