• Own and proactively evaluate, negotiate and resolve auto injury claims in various stages of the claim, from unrepresented to represented to early litigation stages, primarily third-party automobile claims • Able to easily comprehend and apply policy language provisions, conditions and exclusions, incorporating knowledge of applicable state laws and regulations • Responsible for an inventory of primarily attorney represented and legal claims • Able to identify high-risk matters and keep appropriate suspense and actions to reduce unnecessary legal or monetary exposure • Draft coverage position letters and correspondence as needed • Control claim costs and expenses to the extent possible • Able to work across teams in the claim department collaboratively and mentor personnel on coverage and liability concepts, driving accurate decisions and settlement amounts • Identify process improvements to increase efficiency and improve business outcomes • Assist in responding to attorney, regulatory, producer and consumer inquiries

• Coordinates and supports initiatives relative to evaluation, processing, and handling of health insurance applications • Tracks the progress of all enrollments, compiles data to reflect current progress, establishes and monitors goals for the team • Trains and evaluates health center staff on enrollment processes • Verifies patient insurance coverage to ensure necessary visits/procedures are covered

• Reduce outstanding accounts receivable by managing claims inventory • Speak to patients and insurance companies in a professional manner regarding their outstanding balances • Gather information from various sources to register patients, gather or update information, and determine benefits and eligibility • Provide excellent customer service and timely response to questions and issues • Utilize various databases and specialized computer software for revenue cycle activities • Explain charges, answer questions, and communicate requirements regarding patient financial care services

• Handle inbound and outbound calls to prospective clients, creating a friendly and inviting atmosphere to discuss Aetna’s Medicare plans. • Clearly explain Medicare options, benefits, and enrollment processes, ensuring clients feel informed and confident in their choices. • Take the time to understand each client’s unique needs and adapt your approach to provide tailored solutions. • Foster trust and rapport with clients through your outgoing personality and cooperative attitude. • Keep track of leads and follow up promptly, ensuring no opportunity is missed while maintaining accurate records of interactions.