• Under the oversight of the Area Manager, the Claims Examiner III – Team Leader reports to the Claim Supervisor and/or Area Manager and is responsible for managing all aspects of Auto Liability and PIP/No-Fault claims from inception through resolution • Provides day-to-day guidance and technical support to Claims Examiners, ensuring consistency, quality, and adherence to best practices • Helps to establish procedures for American Arbitration Association to help reduce costs and improve process • Investigates and conducts investigations in a timely manner for claims assigned • Communicates with clients, claimants, providers, and vendors regarding claims issues • Computes and sets reserves within Company guidelines • Approves authority requests of direct reports for claims assigned and directs them to obtain authority as designated • Settles and/or finalizes all claims assigned and obtains authority as designated • Maintains diary system for case review and documents file to reflect the status and work being performed on the file assigned • Communicates appropriate information promptly to the Area Manager and client to resolve claims efficiently

• Serves as the primary source for coder inquiries • Reviews documentation for appropriate required elements such as attestations, signatures, dates, etc. • Abstracts and codes surgical procedures from all sections of CPT and cross walks surgical codes to ASA • Codes ICD-10 • Identifies and assigns care team providers • Reviews for medical direction • Works cases that have been escalated by coding staff and provides feedback • Analyzes data and provides required reports for management

• Provide effective leadership and supervision to a team of representatives • Set clear performance expectations and goals for team members and ensure they are aligned with organizational objectives • Coach, mentor, and motivate team members to enhance their skills, performance, and professional development while fostering a positive and collaborative team environment • Address employee concerns, conflicts, and performance issues in a timely and effective manner • Monitor team performance and ensure adherence to established service level agreements (SLAs) and key performance indicators (KPIs) • Analyze team metrics and identify areas for improvement, implementing strategies to enhance productivity and efficiency • Collaborate with cross-functional teams to streamline processes, resolve operational challenges, and optimize workflows • Continuously monitor and improve customer service quality, ensuring high levels of customer satisfaction • Stay updated with industry best practices and trends to drive process improvements and innovation within the team • Identify training needs and coordinate training sessions to enhance the skills and knowledge of team members • Ensure team members are equipped with the necessary tools, resources, and information to effectively perform their roles • Collaborate with other team leads and managers to share best practices and implement consistent processes • Serve as a point of contact for escalations and handle customer inquiries or complaints as needed • Contribute to team meetings and participate in organizational initiatives to drive positive change and growth • Provide reports on team performance as required • Regularly communicate with clients as needed • Adhere to company policies and procedures • Meet or exceed performance targets for related KPIs • Continuously improve knowledge of products, services, and processes by participating in training programs and continuous learning modules • Maintain a positive, empathetic, and professional attitude toward customers and colleagues at all times • Perform other duties as assigned

• Informar al Jefe de Entrega y Operaciones • Liaison con autoridades regulatorias y otros organismos de certificación sobre cuestiones técnicas/regulatorias • Proporcionar liderazgo técnico y experiencia a la red global de dispositivos médicos • Liderar el equipo de evaluadores de productos IVDR y IHC • Desarrollar, actualizar y mantener paquetes de formación apropiados para los evaluadores de productos IVDR • Proporcionar asesoría técnica para apoyar todas las etapas del proceso de evaluación de la conformidad • Contribuir al desarrollo y gestión diaria de las actividades de dispositivos médicos