• Manage real-time work distribution to balance workloads and ensure continuous progress • Monitor account movement across workflow stages and intervene to prevent delays • Identify and escalate workflow bottlenecks or system issues impacting throughput • Lead, coach, and support a team of 8–15 team mates • Provide real-time feedback to improve productivity, quality, and adherence • Conduct 1:1s and performance discussions to reinforce expectations • Track productivity, quality, and cycle time metrics • Address performance gaps quickly and reinforce accountability • Ensure adherence to payer guidelines, internal processes, and regulatory requirements • Maintain audit readiness and enforce HIPAA compliance • Support resolution of complex or escalated accounts • Provide guidance on payer requirements and workflow expectations • Support onboarding and ongoing training for team members

• Review files for coverage, liability and timely handling. • Make handling recommendations and provide direction to team members. • Ensure ongoing processing of claims is within company standards and industry best practices and regulations. • Granting authority to accept, defer or reject a demand is a critical task. • Approving timecards is an important responsibility. • Review BI and UMBI evaluations to verify accuracy and recommend negotiation strategy. • Determine, recommend and grant authority for settlement and payment processes within the designated authority layer. • Assist with training including Decision Net, CMS Reporting Portal, Acrobat Reader Docu-Sign, ISO Claim Search and other processes as requested. • Regularly facilitate team meetings and one-on-one coaching sessions with direct reports. • Assist with various aspects of compiling data for our quarterly Litigation Calibration report. • Assist with assigning new files to members of the BI/Lit team. • Establish follow-up tasks for yourself or for management on all newly assigned BI/Lit files. • Provide ongoing task monitoring throughout the life of the file of certain files and/or file handlers. • Monitor and follow-up on files not worked in 30 days, files closed with open reserves and red/overdue tasks greater than four days delinquent. • Resolve complaint calls within your knowledge and authority and forward the others to management. • Conduct ongoing reserve adequacy reviews and direct reserves be increased when appropriate. • Grant authority to utilize certain approved vendors to assist with getting ANOIs signed and other tasks, and authorize the use of accident reconstructionist to opine in minimum impact claims. • Review vendor and legal invoices and authorize the payment of invoices (with the exception of invoices for the retention of experts, invoices for Trials and invoices over $4000). • Monitor PLDs and TLDs for timely processing and response. • Comply with state and federal laws, Department of Insurance criteria, insurance carrier criteria and follow and enforces Aspire General Insurance Company and partner’s policies, procedures and work rules. • Assist to identify, recruit, hire and develop top claims talent. • Achieve targeted performance goals. • Other duties as assigned.

• Provide supervision, coaching, and engagement to ensure exceptional customer service and achievement of carrier, vendor, and insured KPIs. • Support the implementation of processes, policies, and team standards. • Role model for delivering an exceptional customer experience every time • Establish and maintain positive interactions with internal and external stakeholders. • Assist with overseeing and determining settlement authorizations for team. • Monitor the progress of files, claims, tasks, and queues to ensure compliance. • Adhere to and promote all customer service standards • Ensures sales team milestones and metrics are achieved • Other duties as required • Ability to work overtime or flex schedules during high volume and CAT Events is required

• Oversee day-to-day operations of a team consisting of all elements of the Credentialing process. • Assist in ensuring the coordination of initial and ongoing compliance with National Committee for Quality Assurance (NCQA) and Delta Dental Plans Association standards. • Ensures development and execution of Credentialing and other provider onboarding functions in accordance with applicable department policies and procedures. • Work directly with provider services associates, providers and external clients to ensure satisfaction and timeliness. • Generate performance measures and set goals while monitoring performance against them. • Coordinate directly with the Director of Compliance to ensure alignment with all departmental and company initiatives. • Monitor key performance indicators and metrics to assess provider enrollment & credentialing effectiveness, efficiency, and compliance. • Responsible for continuous process improvement in provider enrollment and credentialing processes. • Maintain all providers’ contractual credentialing information for all Networks including Medicare Advantage and Medicaid. • Run regularly scheduled reports to identify and address any outstanding applications, issues, and expiring information. • Assist in development, implementation and maintenance of processes that support department and organization goals.