Senior claims analyst vs insurance adjuster

Differences between senior claims analyst and insurance 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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Insurance adjuster example responsibilities.

• Achieve targeted performance goals in every aspect to manage costs and support Allstate's industry-leading operational standards.
• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Train in Xactimate estimation and sketch programs.
• Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
• Skil in complex arbitration and mediation negotiations.
• Recommend files for arbitration or litigation base on evidence available and inability to compromise with adverse party.
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