• To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims. • To coordinate case management within Company standards, industry best practices and specific client service requirements. • To manage the total claim costs while providing high levels of customer service. • Analyzes and processes complex or technically difficult medical malpractice and long term care claims by investigating and gathering information to determine the exposure on the claim. • Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. • Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. • Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. • Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. • Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. • Represents Company in depositions, mediations, and trial monitoring as needed. • Communicates claim activity and processing with the client; maintains professional client relationships. • Ensures claim files are properly documented and claims coding is correct. • Refers cases as appropriate to supervisor and management.

• Claims Assessment: Review and evaluate trucking claims submitted by clients to determine their validity, coverage, and potential payouts. • Conduct thorough investigations to collect relevant information from various parties involved, including drivers, trucking companies, and insurance adjusters. • Cost Analysis: Utilize your expertise to analyze maintenance records, repair invoices, and other documentation to accurately calculate truck and trailer maintenance costs. • Documentation and Reporting: Maintain accurate and comprehensive records of all claims, communications, and decisions made throughout the claims process. • Customer Communication: Serve as the primary point of contact for clients during the claims process. • Regulatory Compliance: Stay informed about industry regulations, company policies, and best practices related to claims processing. • Continuous Improvement: Collaborate with team members to identify opportunities for improving claims processing efficiency and accuracy.

• Work with the User Support Team to resolve participant claim issues by responding to questions and resolving tickets in our ticketing system • Provide back up for User Support Team as needed – answering calls from participants and service delivery staff • Process client claims and service provider invoices in case management system accurately and ensures contractual and legislative requirements are met • Review, process, and invoice all RSVP services to the contractual standard as needed • Provide quality assurance for claims/invoices processed by other Claims Specialists • Answer inquiries from field staff regarding claims and other administrative questions via phone and secure message • Prepare cheques and EFT payments • Filing, mailing, scanning and other administrative tasks

• Investigating, evaluating, and settling auto physical damage claims within assigned territory • Conducting timely and thorough investigations • Verifying applicable coverages • Analyzing potential exposure and deductible • Estimating damages and evaluating for reserve and settlement • Resolving claims through effective negotiation, settling and/or denial • Maintaining relationships with underwriting, risk control, marketing and the independent agency force • Participating in continuing educational programs