Worker's compensation claims examiner vs auto claims adjuster

Differences between worker's compensation claims examiner and auto claims adjuster duties and responsibilities

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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Auto claims adjuster example responsibilities.

• Manage file inventory by utilizing CCC pathways diary system documenting claim file activities in accordance with establish procedures
• Work closely with staff attorneys to develop litigation strategies and prepare for depositions.
• Provide feedback and implement strategies on claim investigation, reserving, settlement and litigation.
• Research and review delinquent mortgage cases, financial scenarios and individual homeowner situations to develop solutions compliant with investor policy.
• Prepare written arguments for arbitration and provide all supporting documentation and evidence.
• Compile and submit arbitration applications against the insurers of at-fault parties who refuse liability.
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