Senior claims analyst vs adjuster

Differences between senior claims analyst and adjuster duties and responsibilities

Senior claims analyst example responsibilities.

• Accomplish facets and Macess user including running reports.
• Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
• Coordinate the maintenance of TPA payment type / code table conversions data.
• Process claims, generate checks, create reports and correspond with TPA clients.
• Review claims for correct billing information such as correct CPT codes, ICD code and patient information.
• Analyze, evaluate, and conduct statistical data reviews as required by CMS in accordance with ZPIC policies.
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Adjuster example responsibilities.

• Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
• Review evidence obtain in liability investigations to evaluate a claim for success in recovery through litigation or arbitration.
• Document measurements and relevant data to author estimates and appraisals utilizing Xactimate 28software.
• Charge with answering and defending policy holders and company interests through independent and binding third-party arbitration proceedings.
• Review departmental reports and financial data; prepare reports of findings, negotiating settlement demands or recommending litigation.
• Prepare computerize estimates utilizing Xactimate and document all activity associate with the claim in clients web base claims management system.
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