Adjudicator vs appeals examiner

The differences between adjudicators and appeals examiners can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both an adjudicator and an appeals examiner. Additionally, an appeals examiner has an average salary of $58,096, which is higher than the $40,918 average annual salary of an adjudicator.

The top three skills for an adjudicator include disability claims, state laws and personnel security. The most important skills for an appeals examiner are appeals, CPT, and medical terminology.

Adjudicator vs appeals examiner overview

	Adjudicator	Appeals Examiner
Yearly salary	$40,918	$58,096
Hourly rate	$19.67	$27.93
Growth rate	-1%	-1%
Number of jobs	95	2,094
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 41%
Average age	46	46
Years of experience	4	4

Adjudicator vs appeals examiner salary

Adjudicators and appeals examiners have different pay scales, as shown below.

	Adjudicator	Appeals Examiner
Average salary	$40,918	$58,096
Salary range	Between $29,000 And $56,000	Between $39,000 And $84,000
Highest paying City	-	-
Highest paying state	-	-
Best paying company	-	-
Best paying industry	-	-

Differences between adjudicator and appeals examiner education

There are a few differences between an adjudicator and an appeals examiner in terms of educational background:

	Adjudicator	Appeals Examiner
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 41%
Most common major	Business	Law
Most common college	University of Pennsylvania	Stanford University

Adjudicator vs appeals examiner demographics

Here are the differences between adjudicators' and appeals examiners' demographics:

	Adjudicator	Appeals Examiner
Average age	46	46
Gender ratio	Male, 32.6% Female, 67.4%	Male, 40.0% Female, 60.0%
Race ratio	Black or African American, 5.7% Unknown, 4.4% Hispanic or Latino, 7.9% Asian, 6.5% White, 75.2% American Indian and Alaska Native, 0.3%	Black or African American, 4.1% Unknown, 4.2% Hispanic or Latino, 6.2% Asian, 5.0% White, 80.2% American Indian and Alaska Native, 0.3%
LGBT Percentage	10%	10%

Differences between adjudicator and appeals examiner duties and responsibilities

Adjudicator example responsibilities.

Manage appeals and authorizations by examining information and performing necessary adjustments.
Report (Medicaid rejects).
Identify and resolve deny claims prior to medication delivery, working with nursing facilities, insurance companies and Medicaid.
Schedule additional investigation to resolve issues and obtain document evidence to support OPM's decision.
Perform monthly and quarterly QCP and ACA audits.
Administer oaths, enter evidence into record and make decisions regarding those arrest for DUI.

Appeals examiner example responsibilities.

Remain compliant with CMS by complying with TMS regulations and helping achieve ISO certification.
Exemplify superior and quality customer service; assist providers with appeals via phone, mail, or peer to peer.
Receive documentary and testimonial evidence and apply pertinent federal and state law to prepare recommend orders deciding appeals.
Blood collection by venipuncture and capillary technique ensure all specimens are collect accurately, on time and according to establish procedures.
Reconsider determination for disputes between Medicare and Medicaid beneficiaries.

Adjudicator vs appeals examiner skills

Common adjudicator skills

Disability Claims, 16%
State Laws, 13%
Personnel Security, 10%
Social Security Administration, 9%
Background Investigations, 7%
Disability Benefits, 6%

Common appeals examiner skills

Appeals, 37%
CPT, 19%
Medical Terminology, 19%
Legal Research, 11%
Unemployment Insurance, 8%
CMS, 6%

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Adjudicator
Adjudicator vs Appeals Examiner

Updated January 8, 2025

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