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...