Litigation claim representative vs worker's compensation claims examiner

Differences between litigation claim representative and worker's compensation claims examiner 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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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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