Social insurance administrator vs claims coordinator

Differences between social insurance administrator and claims coordinator duties and responsibilities

Social insurance administrator example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Resolve issues that arise concerning private insurance and Medicaid claims and collections.
• Assist patients by updating and correcting statement errors, and annotate additional billing information request on the behalf of insurance company.
• Update policy and training to employees on all HMO & PPO policy changes.
• Select to distribute communications to team including creating PowerPoint's and emails.
• Be professional in all communications, act in a manner consistent with Assurant values and honor Assurant s commitments.

Claims coordinator example responsibilities.

• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
• Serve as point of contact for all legal issues relate to HIPAA.
• Streamline audit procedures of TPA and maintain extremely high production rate which help in keeping staffing requirements lower.
• Review and audit claims -Using correct CPT and DX codes -Denial reports -correct billing error, resubmitted claims for proper payment
• Communicate with company management, injure workers/customers, medical providers and TPA, as necessary, regarding claim relate matters.
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