Home office claims examiner vs claims supervisor

Differences between home office claims examiner and claims supervisor duties and responsibilities

Home office claims examiner example responsibilities.

• Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
• Review and approve new applications in accordance to CIP guidelines.
• Provide technical support and direction as to case management, experts, litigation management and final authority on reportable claims.
• Participate in business process redesign in claims and litigation.
• Provide oversight for quarterly system testing ensuring system integrity are not compromise by directing consistent testing practices across multiple groups.
• Negotiate settlements and file arbitration or hire counsel when warrant.

Claims supervisor example responsibilities.

• Manage, train and continuously develop a team consisting of both inside SIU investigators and field investigators.
• Apply fundamentals of insurance investigation and resolution to an introductory leadership role managing complex claim files and tort litigation files.
• Make determinations to authorize payments via XACTIMATE software.
• Assist TPA in obtaining company documentation and scheduling employee interviews in investigation of claims.
• Advise physician on any changes with CPT and ICD-9 coding to maximize reimbursements and minimize denials.
• Provide oversight and direction for highly complicate claim reviews base on policy, procedure and CMS guidelines.
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