Claims vice president vs claims director

Differences between claims vice president and claims director 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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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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