Claims director vs liability claims examiner

Differences between claims director and liability claims examiner duties and responsibilities

Claims director example responsibilities.

• Create project team that comply with new Medicare reporting requirements achieving successful reporting to CMS.
• Maintain relationships with attorneys and manage litigation strategy; ensure strong relationships with insureds, brokers and third party administrators.
• Redesign processes and procedures for managing litigation through the implementation of an aggressive process for managing discovery and case typing.
• General knowledge of CPT, ICD-9, HCPCS, DRG and Medicode (UCR), bundling and unbundling.
• File and respond to online arbitration matters.
• Facilitate annual updates to all new and revise CPT codes assuring accurate claims payment.
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Liability claims examiner example responsibilities.

• Handle automobile liability, general liability, products liability and manage litigation for one specific client.
• Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
• Oversee adjustment of all third-party liability losses, coverage assessment, investigation, and evaluations regarding litigation claims.
• Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
• Interact with assign counsel for case status, interrogatories and preparation for trials on calendar.
• Investigate and identify fraud claims and partner with SIU for additional investigations to prevent payouts after fraud are proven.
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