• Organize, develop, and mentor a team of PIP claims adjusters. • Assign and prioritize workload to ensure timely and accurate claims processing. • Conduct regular team meetings to provide updates, address concerns, and promote a collaborative work environment. • Review complex or high-value PIP claims for accuracy and compliance with company policies and state regulations. • Provide guidance and expertise to claims adjusters on challenging cases. • Monitor claims progress to ensure timely resolution and adherence to service level agreements. • Implement and maintain quality assurance processes to ensure claims accuracy and compliance. • Conduct audits and provide constructive feedback to claims adjusters for continuous improvement. • Develop and deliver training programs to enhance the skills and knowledge of claims adjusters. • Collaborate with customer service teams to address customer inquiries and concerns related to PIP claims.

• Manage the customer service team (L1 and L2), overseeing performance, daily routines, and employee development • Ensure monitoring and progress of operational requests, guaranteeing deadlines and quality in handling • Support the team in resolving more complex incidents and operational critical issues • Monitor performance indicators (KPIs) and propose actions for continuous operational improvement • Organize and distribute incoming requests among the team • Ensure compliance with processes and operational standards • Interface with internal teams and partners to align and advance requests • Participate in operational meetings to ensure activity alignment and set priorities • Support identification of improvements in processes and operational routines • Track ticket volumes and manage queues and deadlines • Act as the operation's focal point, supporting the team in resolving requests and ensuring smooth execution of activities • Monitor and ensure the quality of service, working on continuous process improvements • Contribute to internal and external communication, promoting alignment between the team, departments, and partners

• Lead the complaint resolution function, overseeing a team of resolution specialists • Ensure resolution processes are consistent, compliant with HIPAA, CMS, TDI, and internal policy standards, and continuously improving • Serve as the primary cross-functional liaison between the contact center, Legal, Compliance, Quality Assurance, and Operations • Act as the final escalation point for the most complex and sensitive member issues • Direct and supervise team research and analysis of all incoming member and provider complaints to determine root causes and appropriate corrective actions • Develop, implement, and continuously refine resolution methodologies and SOPs for complex member issues • Maintain integrity of the complaint tracking system; ensure all complaint details, investigation steps, resolutions, and follow-up activities are documented • Ensure all complaint-handling procedures adhere to internal policies and applicable regulations • Design and manage proactive member and stakeholder follow-up processes to confirm resolution satisfaction and mitigate issue recurrence • Generate and formally present comprehensive reports on complaint trends, resolution cycle times, and compliance metrics to senior leadership • Develop and oversee the contact center QA program, including call monitoring, transaction review, scoring calibration, and SOP maintenance • Coach, develop, and performance-manage resolution team members; drive process improvement using Lean, Six Sigma, or similar methodologies

• Manage individual and team delivery against the service agent performance framework: Contact Delivery, Customer Impact, and CSC Standards. • Monitor real-time phone behaviors, break thresholds, and after-call wrap times. • Collaborate and manage performance root cause analysis and action plans to help identify performance gaps. • Lead, monitor, motivate, and evaluate the day-to-day performance at team and individual level. • Ensure company processes and procedures are adhered to by team and individuals. • Partner with the quality, operations, product and service support team to ensure compliance requirements are met. • Collaborate cross-functionally to align day-to-day operational initiatives with the broader customer experience strategy. • Oversee Zendesk queue management, prioritizing complex requests for internal and external customers. • Guide the team through automated digital shifts, Gen AI auto-reply rollouts for automated servicing. • Support skill diversification across both licensed and unlicensed agents to distribute workloads evenly and reduce bottlenecks. • Support cross-departmental efforts to overall Objective Key Results including effective call routing, IVR re-routes, and chatbot deployment.