Claims vice president vs claim specialist

Differences between claims vice president and claim specialist duties and responsibilities

Claims vice president example responsibilities.

• Retain and manage outside counsel; develop and coordinate strategy for litigation; participate in alternative dispute resolution and negotiate settlements.
• Provide management oversight of client support at offices in Indiana, Kentucky and Ohio.
• Provide vision, oversight and direction to claims and encounter processing and claims systems configuration.
• Work with underwriting carrier to ensure that all TPA responsibilities are being handle according to the TPA guidelines.
• Establish and direct internal and external performance standards and procedures for use with TPA's or general agents.
• Negotiate claims litigation, including settling lawsuits via mediation strategies.
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Claim specialist example responsibilities.

• Assist in the streamlining of EDI process to manage workflow of EDI claims.
• Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
• Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
• Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
• Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
• Manage expedition of appeals via problem solving and collaboration with other departments.
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