Litigation claim representative vs claim specialist

Differences between litigation claim representative and claim specialist duties and responsibilities

Litigation claim representative example responsibilities.

• Manage assigned third party administration (TPA) multi-jurisdictional workers' compensation; subrogation recovery claims; assign defense attorney.
• Resolve no-fault disputes in the arbitration forum and court system in accordance with no-fault regulation and laws.
• Guide defense counsel throughout litigation process, securing compliance with corporate objectives and guidelines.
• Assist in depositions and interrogatories of inspectors.
• Review summons and complaints receive from medical providers attorneys.
• Monitor closely and provide directive on every case through litigation till resolution are reached.
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Claim specialist example responsibilities.

• Assist in the streamlining of EDI process to manage workflow of EDI claims.
• Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
• Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
• Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
• Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
• Manage expedition of appeals via problem solving and collaboration with other departments.
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