Liability claims representative vs worker's compensation claims examiner

Differences between liability claims representative and worker's compensation claims examiner duties and responsibilities

Liability claims representative example responsibilities.

• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Investigate and conclude property and casualty liability claims including those in litigation with the highest overall production of the claims representatives.
• Participate in arbitration hearings through writing contentions, compiling evidence and personally representing files.
• Control expenses by developing and following resolutions and/or litigation plans to drive claim to resolution.
• Facilitate training seminars for new employees to familiarize them with various corporate procedures including exposure recognition, fraud detection and arbitration.
• Complete field inspection of losses including accurate scope of damages, photographic evidence collection, written estimates utilizing Xactimate estimating software.
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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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