Opportunity Description
Opportunity
We’re looking for Healthcare Service Advisors to join our Healthcare Services team to ensure timely and equitable resolution of sophisticated Accident Benefit claims.
What you’ll do
- Interpret insurance contracts, resolve policy coverages, and establish/adjust reserves in accordance with corporate guidelines.
- Handle Accident Benefits claims according to individual authority, knowledge, and expertise.
- Acquire investigative reports, independent medical examinations, statements from insureds/witnesses, and other specialists as required.
- Educate customers and providers on any new auto reform changes.
- Ensure adherence to internal policies and quality standards (Compliance & Governance).
- Actively coordinate customers’ functional recovery, ensuring treatment goals are monitored.
- Assist in resolving claims issues related to legislation interpretation and settlement negotiations.
- Ensure...
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