Liability claims examiner vs worker's compensation claims examiner

Differences between liability claims examiner and worker's compensation claims examiner 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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Worker's compensation claims examiner example responsibilities.

• Manage all aspects of claims, including heavy litigation and vocational rehabilitation cases.
• Negotiate settlements and actively manage the litigation process and process complex and technically difficult claims.
• Determine benefits when processing medical claims receive as HCFA and UB92 paper claims or electronically.
• Set up vehicle inspections, and rental reservations as a part of the claim settlement process.
• Handle incoming calls from customers and providers with policy changes and claim status updates and maintain HIPAA.
• Process claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and provider settlements and Medicaid claims.
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