Worker's compensation claims examiner vs examiner

Differences between worker's compensation claims examiner and examiner 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.
Show more

Examiner example responsibilities.

• Manage country wide litigate and non-litigate claims for TPA construction program.
• Manage Kemper's internal loss control and claims for all Kemper employees and offices.
• Manage complex and significantly consequential litigation as well as sensitive cases involving catastrophic injuries and fatality.
• Manage litigation costs (defense/consultants/independent investigators/experts).
• Engage in mediation, arbitration hearings, discovery proceedings, settlement conferences, and trials.
• Draw blood, collect urine, run EKG'S and collect medical history on clients to obtain life insurance policies.
Show more