Insurance analyst vs claims supervisor

Differences between insurance analyst and claims supervisor 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 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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