Senior claims processor vs liability claims examiner

Differences between senior claims processor and liability claims examiner duties and responsibilities

Senior claims processor example responsibilities.

• Manage confidential medical records and directs them to the appropriate practitioners while ensuring HIPPA regulations are maintain.
• Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
• Process CalPERS HMO facility claims.
• Experience with HMO's, IPA's and insurance authorizations.
• Handle confidential information according to new laws (HIPPA).
• Review ICD-9 diagnosis codes against CPT codes for claim payment guidelines.
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Liability claims examiner example responsibilities.

• Handle automobile liability, general liability, products liability and manage litigation for one specific client.
• Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
• Oversee adjustment of all third-party liability losses, coverage assessment, investigation, and evaluations regarding litigation claims.
• Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
• Interact with assign counsel for case status, interrogatories and preparation for trials on calendar.
• Investigate and identify fraud claims and partner with SIU for additional investigations to prevent payouts after fraud are proven.
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