• Review and monitor customer reviews on a daily basis • Investigate and respond to negative reviews in a timely and professional manner • Contact customers via phone and email to resolve complaints • De-escalate tense or sensitive situations with confidence and empathy • Guide customers towards a resolution by following company policy. • Stand firm where necessary while maintaining professionalism • Escalate matters internally when appropriate • Ensure resolutions align with company policies and legal standards

• Review the case records: medical records, pictures, police reports, income statements, etc. • Analyze records to come to proper demand for settlement. • Write demand letters and other correspondence. • Make calls to adjusters to negotiate claims. • Communicate to the client while providing exceptional customer service. • Updating clients regularly as to the status of their case. • Process the necessary paperwork to accept settlement: release, negotiation, and satisfaction of medical liens, and the distribution of funds. • Prioritize work based on a case list. • Respond to emails, calendars, etc. • Update Litify (Sales Force) case management.

Role Description The Grievance and Appeals (G&A) Claims Analyst is responsible for the end-to-end processing of appeals, grievances, and medical claim disputes received from members, providers, and regulatory agencies. This is a high-level analytical role that requires "thinking on your feet" to resolve a backlog of medical claim cases. - Conduct deep-dive research into internal/external resources. - Review contracts and apply complex rules to determine if a claim is acceptable. - Facilitate managerial-level conferences and negotiate resolutions. - Document every step of the process. - Communicate final decisions via formal written correspondence that meets strict corporate and regulatory accuracy guidelines. Qualifications - High-Level Analytical & Logical Mindset: Ability to examine facts and contextual information to make confident, assertive, and persuasive decisions. - Advanced Claims Expertise: Proven experience reading, analyzing, and reviewing claims at a high level. FACETS or NASCO experience is a significant advantage. - Superior Communication: Outstanding verbal skills for conferences and expert-level writing skills for formal documentation. - Research & Logic: Ability to interpret contracts, apply policies/procedures, and structure thorough, logic-based responses. - Fast-Paced Delivery: Comfortable managing tight deadlines and high-quality standards in a remote environment. - Technical Proficiency: Strong PC skills, including the MS Office Suite and the ability to navigate multiple complex databases simultaneously. - Confidentiality: High regard for protecting member, employee, and corporate information. - Professional Background: Previous experience in a concierge or high-end customer service setting (beyond standard CSR roles). Requirements - Legal Background: Experience working in a legal setting, paralegal experience, or contract review is a major plus. - Subject Matter Expertise: Background in research and formal writing. - Bachelor’s Degree Required. Preferred Majors: English/Writing, Health Care Administration, History, Juris Doctorate (JD), Paralegal Studies, or Political Science. Benefits - Market-relevant benefits. - Opportunities for professional growth.

Location: Remote (South Africa) About the Company Emmington is an international portfolio of companies operating across the UK, USA, Australia, New Zealand, and Dubai. We partner with businesses that are focused on improving customer acquisition and driving sustainable growth. Our portfolio includes both B2B and B2C businesses. Across the Emmington portfolio, we own, invest in, and consult for a range of businesses. While our level of involvement may vary, all companies we work with meet the same core criteria: they are growth-focused, performance-driven, and committed to scaling effectively. Role Overview We are seeking a proactive and confident Junior Paralegal to join our team. This is a fully remote role for a South Africa–based candidate who is legally knowledgeable, customer-focused, and skilled at handling escalations with professionalism and confidence. This role sits at the intersection of legal support and customer experience. You will be responsible for reviewing customer feedback daily, addressing negative reviews, and engaging directly with customers to resolve concerns effectively and professionally. Key Responsibilities - Review and monitor customer reviews on a daily basis - Investigate and respond to negative reviews in a timely and professional manner - Contact customers via phone and email to resolve complaints - De-escalate tense or sensitive situations with confidence and empathy - Provide legally sound guidance when required - Stand firm where necessary while maintaining professionalism - Escalate matters internally when appropriate - Ensure resolutions align with company policies and legal standards Requirements - Relevant legal qualification or paralegal background - Strong understanding of applicable legal principles - Excellent written and verbal communication skills - Confident, friendly, and professional phone manner - Extroverted and comfortable engaging directly with customers - Ability to think critically and respond under pressure - Strong conflict resolution and de-escalation skills - Highly organised and able to manage daily review volumes Candidates will be placed within one of the Emmington portfolio companies.