Liability claims examiner vs claims supervisor

Differences between liability claims examiner and claims supervisor duties and responsibilities

Liability claims examiner example responsibilities.

• Handle automobile liability, general liability, products liability and manage litigation for one specific client.
• Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
• Oversee adjustment of all third-party liability losses, coverage assessment, investigation, and evaluations regarding litigation claims.
• Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
• Interact with assign counsel for case status, interrogatories and preparation for trials on calendar.
• Investigate and identify fraud claims and partner with SIU for additional investigations to prevent payouts after fraud are proven.
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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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