Insurance assistant vs telephone claims representative

Differences between insurance assistant and telephone claims representative duties and responsibilities

Insurance assistant example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Analyze Medicaid models, Medicare and HIPAA transaction documents.
• Assign ICD-9 and CPT codes to office visit and inpatient and outpatient procedures.
• Process electronic claims, pre-existing and subrogation investigation, point of service, and PPO and HMO processing.
• Train staff on billing software in regards to CPT codes and pricing, submission procedures, and industry regulations.
• Perform verification of Medicare and Medicaid coverage and limits.
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Telephone claims representative example responsibilities.

• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Draft contentions for arbitration and submit evidence to support those contentions.
• Negotiate liability with other insurance companies when possible, review files and documents for arbitration process.
• Complete field inspection of losses including accurate scope of damages, photographic evidence collection, written estimates utilizing Xactimate estimating software.
• Set up payment arrangements with the at-fault party that cause harmed to the GEICO insure.