- Adjust time-intensive, complex, and high exposure Allied Health claims.
- Conduct coverage analysis and identify potential coverage questions.
- Draft reservation of rights and coverage denials for management review.
- Investigate facts of loss by securing statements and supporting documentation.
- Manage litigation by assigning and directing defense counsel, independent adjusters, and experts.
- Evaluate, set, and recommend reserves based on exposure and claim trajectory.
- Lead strategic roundtable discussions to determine resolution strategy.
- Present analysis and status updates to Senior and Program Executives.
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