Litigation claim representative vs claims supervisor

Differences between litigation claim representative and claims supervisor 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 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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