Claims adjuster supervisor vs field investigator

Differences between claims adjuster supervisor and field investigator duties and responsibilities

Claims adjuster supervisor example responsibilities.

• Manage file inventory by utilizing CCC pathways diary system documenting claim file activities in accordance with establish procedures
• Audit pending case loads to determine exposures involve, direct litigation management and report to excess/re-insurers pursuant to retention levels.
• Mitigate medical expenses by recognizing improper billing of CPT and ICD9 codes.
• Initiate and answer arbitration cases.
• Serve as an arbitration panelist for intercompany arbitration cases.
• Attend depositions when require and coordinate litigation files with in-house counsel.
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Field investigator example responsibilities.

• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Conduct SIU investigations and activity checks/interviews.
• Complete advanced SIU training in arson investigation, forensics, interrogation and statistical analysis.
• Investigate and open cases on customers and non-customers who have potentially engage in activity which goes against federally mandate BSA/AML regulations.
• Work with lawyers, insurance investigators, medical providers, Medicaid clients, and co-workers to resolve issues.
• Complete additional training and implementation of health insurance billing, both commercial and government (Medicare and Medicaid).
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