Year 2 Learning Objectives

* Gain working knowledge of medical terminology, evaluate medical reports, and understand clinical treatment plans to support accurate claim assessments.
* Coordinate physical rehabilitation, control pharmacy costs through formularies, manage chronic opioid use, and adapt to evolving regulations, including medical marijuana.
* Comprehend when MSAs are necessary, how they are calculated, and ensure compliance with federal mandates.
* Identify red flags for fraudulent claims, utilize investigative strategies, and ethically manage questionable case activity.
* Understand how occupational illnesses differ from injuries, including causation complexities and long-latency exposure issues.
* Apply reserving best practices, forecast long-term claim costs, and support defensible financial management.
* Measure program effectiveness using claim loss runs, safety committee outcomes, and employee training initiatives.
* Analyze loss development data and reporting packages to identify trends, improve decision-making, and reduce claim frequency and severity.
* Identify and understand the motivations of key decision-makers and maintain strong relationships with internal teams, medical providers, and external partners.
* Deliver clear, persuasive updates and presentations, and effectively manage interactions across all levels of the claims process.