Job Summary

• Management and administration.
• Market intelligence.
• Claims Specialist.
• Performance Management.
• Fraud management.

Key Responsibilities

• Regular review of open files to identify root causes of claims leakage and translate findings into action plans to reduce leakage through process improvements and/or training.
• Manage specialized claims from notification up to settlement, overseeing the progress of adjusters' investigation.
• Periodic monitoring of outstanding claim files with adjusters.
• Review work processes and provide solutions to improve claim guidelines and processes.
• Assist in departmental administrative work, systems, and procedures for smooth operations and continuous improvement.
• Investigate potential fraud cases to uncover fraud patterns and parties involved.
• Develop claim review plans (including outstanding and close...