Health claims examiner vs liability claims representative

Differences between health claims examiner and liability claims representative duties and responsibilities

Health claims examiner example responsibilities.

• Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
• Review and analyze medical claims to finalize payments according to Medicaid benefits.
• Analyze and process Medicare and Medicaid claims (Primary/Secondary).
• Blood collection by venipuncture and capillary technique ensure all specimens are collect accurately, on time and according to establish procedures.
• Coordinate vendor referrals for additional investigation and/or litigation management

Liability claims representative example responsibilities.

• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Investigate and conclude property and casualty liability claims including those in litigation with the highest overall production of the claims representatives.
• Participate in arbitration hearings through writing contentions, compiling evidence and personally representing files.
• Control expenses by developing and following resolutions and/or litigation plans to drive claim to resolution.
• Facilitate training seminars for new employees to familiarize them with various corporate procedures including exposure recognition, fraud detection and arbitration.
• Complete field inspection of losses including accurate scope of damages, photographic evidence collection, written estimates utilizing Xactimate estimating software.
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