Litigation claim representative vs claims director

Differences between litigation claim representative and claims director 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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Claims director example responsibilities.

• Create project team that comply with new Medicare reporting requirements achieving successful reporting to CMS.
• Maintain relationships with attorneys and manage litigation strategy; ensure strong relationships with insureds, brokers and third party administrators.
• Redesign processes and procedures for managing litigation through the implementation of an aggressive process for managing discovery and case typing.
• General knowledge of CPT, ICD-9, HCPCS, DRG and Medicode (UCR), bundling and unbundling.
• File and respond to online arbitration matters.
• Facilitate annual updates to all new and revise CPT codes assuring accurate claims payment.
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