Insurance investigator vs insurance adjuster

Differences between insurance investigator and insurance adjuster duties and responsibilities

Insurance investigator example responsibilities.

• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Research commercial coverage plans and government plans such as Medicare and Medicaid.
• Follow all HIPPA guidelines and procedures to protect patients and company interest.
• Analyze high risk transaction activity and provide final approval of investigative case analyses utilize for SAR preparation and filing.
• Prepare facility specific HIPAA authorizations for release of records.

Insurance adjuster example responsibilities.

• Achieve targeted performance goals in every aspect to manage costs and support Allstate's industry-leading operational standards.
• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Train in Xactimate estimation and sketch programs.
• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Skil in complex arbitration and mediation negotiations.
• Recommend files for arbitration or litigation base on evidence available and inability to compromise with adverse party.
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