• The primary job function is to investigate and manage Personal Injury Protection (PIP) Claims. • Identifies and contacts each injured party to explain coverage and claims process. • Verifies coverage, eligibility and determines the Company’s course of action. • Maintains claims files, evaluates claims using facts and supporting data on injury and wages lost due to injury. • Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the analysis and settlement options. • Verifies the nature and extent of injury and/or wages lost by obtaining and reviewing appropriate records and documentation. • Carefully and thoroughly reviews all pertinent information and forwards the file to the Special Investigations Unit (SIU) when there is reasonable cause. • Reviews and analyzes all information and submits request for payment of claims within company guidelines to supervisor. • Thoroughly documents injury and treatment information as well as bills received for treatment and payments issued. • Contacts medical providers and injured parties to verify medical provider information, treatment received, and billing status. Submits files to supervisor for audit upon closing. • Maintains current knowledge of claims settlement procedures, state regulation, and policy changes. • Includes completion of the formal claims training program, which may require overnight travel for at least 1 week.

• Investigate and document property claims, including policy review, recorded statements, assigning inspections, updating reserves, preparing or reviewing estimates, and negotiating settlements • Communicate claim updates and decisions verbally and in writing • Handle claims in compliance with all applicable regulations and internal processes • Provide technical expertise and serve as an SME for Claims-related projects • Act as a resource for less experienced staff • Support catastrophe response as needed, to include potential overtime and deployment • Any other duties needed to help drive our purpose and fulfill our values

• Investigate and document property claims, including policy review, recorded statements, assigning inspections, updating reserves, preparing or reviewing estimates, and negotiating settlements • Communicate claim updates and decisions verbally and in writing • Handle claims in compliance with all applicable regulations and internal processes • Provide technical expertise and serve as an SME for Claims-related projects • Act as a resource for less experienced staff • Support catastrophe response as needed, to include potential overtime and deployment • Any other duties needed to help drive our purpose and fulfill our values • Lead high-profile and sensitive special investigations involving intricate and specialized fraud referrals.

Role Description The job profile for this position is Business Project Senior Advisor, which is a Band 4 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Position Summary: Leads key components of large, high‑priority projects within PX&O Claim, with a primary focus on Proclaim Auto Adjudication, Claim Attachments, and automation initiatives. Serves as the business lead, partnering closely with technology teams to define scope, set priorities, manage risks, and deliver solutions on time. Uses Agile methods to drive enterprise initiatives, align stakeholders, and ensure the business is ready for successful implementation. Key Responsibilities - Identify and lead initiatives that improve efficiency, quality, and service across PX&O Claim operations. - Provide data, insights, and business context to support leadership decision‑making and prioritization. - Act as the Business Lead for Proclaim Auto Adjudication, partnering with business SMEs and Core Technology. - Lead technology consultants delivering robotic process automation for complex claim processes. - Apply Agile practices to define epics, features, and user stories; influence backlog priorities to meet business needs. - Approve solution designs and testing criteria; partner with operations and change management to ensure readiness. - Provide clear status updates, manage risks, and track outcomes to measure business impact. - Offer thought leadership in business project management and mentor less‑experienced analysts. Qualifications - High School Diploma or GED required. Bachelor’s degree preferred. - 10+ years Provider Claims operations experience, including Proclaim medical claim operations required. - 5+ years of experience in driving claim automation and process improvement initiatives highly preferred. - Deep knowledge of Provider Experience and Claim Operations; recognized as a subject‑matter expert. - Strong project management and organizational skills with the ability to manage multiple initiatives, often using Agile methodologies. - Proven ability to collaborate and influence in a matrixed environment. - Strategic thinker with strong problem‑solving skills. - Excellent written and verbal communication skills. - Ability to work independently in a fast‑paced, remote environment with a strong customer focus. Requirements - If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. Benefits - Comprehensive range of benefits focusing on supporting your whole health. - Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of your employment. - 401(k), company paid life insurance, tuition reimbursement. - A minimum of 18 days of paid time off per year and paid holidays. - This role is anticipated to be eligible to participate in an annual bonus plan. Company Description Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.