Insurance analyst vs claims representative

Differences between insurance analyst and claims representative duties and responsibilities

Insurance analyst example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Organize and examine medical records for physical therapy clinics for patients, attorneys and disability insurance claims.
• Verify insurance benefits for specialty medications cover under both pharmacy and major medical benefits and communicate coverage to patients and physicians.
• Prepare project kickoff PowerPoint presentation for client site visits.
• Review retail and wholesale files to submit to FHA for HUD insuring.
• Provide supporting documentation and reconciliation reports for monthly close and billing using GAAP.
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Claims representative example responsibilities.

• Perform initial set-up and continuously manage claims in the Juris claims management system.
• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Prepare necessary state filings within statutory limits, manage litigation and vocational rehabilitation process, used appropriate cost containment techniques.
• Assist the training department in developing CSR training in order to set expectations.
• Create custom templates and guide sheets for new trainees in the CSR Internet division to ensure consistency and increase department efficiency.
• Utilize proper SIU reporting procedures for extensive investigation as required.
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