Claims reviewer vs customer service associate

Differences between claims reviewer and customer service associate duties and responsibilities

Claims reviewer example responsibilities.

• Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
• Review worker comp claims base on state fee schedule and ICD-9 guidelines.
• Research ICD-9 codes and verify they are equivalent with customer s diagnoses.
• Review accounts per OCC guidelines that all efforts are met and due diligence complete.
• Research claims, review document findings and execute OCC approve harm test for each file.
• Help maintain company compliance with FDA and ICH Regulations/Guidelines governing the reporting of adverse event reports.
Show more

Customer service associate example responsibilities.

• Manage and calculate daily cash deposits and prepare daily payroll ledgers.
• Manage cash balances and inventory stock accurately; ensure cleanliness of all work stations and guarantee excellent customer service.
• Use excellent phone and customer service etiquette while navigating through multiple windows simultaneously.
• Provide excellent customer service to hundreds of satisfy customers, bag groceries with speed and efficiency
• Perform upselling on every call.
• Train in flight emergencies, hazardous materials and CPR.
Show more