Claims vice president vs senior claims specialist

Differences between claims vice president and senior claims 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.
Show more

Senior claims specialist example responsibilities.

• Manage assigned third party administration (TPA) multi-jurisdictional workers' compensation; subrogation recovery claims; assign defense attorney.
• Work toward settlement with claimants and attorneys, or determine company litigation strategy, participating in mediation and arbitration when necessary.
• Maintain EDI processing table logic.
• Work with testing HIPAA transactions, reporting and processing data reporting to the state.
• Review data entry of claims receive through the EDI system for accuracy prior to processing.
• Operate within all company regulations regarding HIPAA, fraud, confidentiality, and private health information guidelines.
Show more