Claim approver vs claim specialist

The differences between claim approvers and claim specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a claim approver and a claim specialist. Additionally, a claim approver has an average salary of $44,986, which is higher than the $43,164 average annual salary of a claim specialist.

The top three skills for a claim approver include process claims, medical terminology and disability claims. The most important skills for a claim specialist are customer service, litigation, and patients.

Claim approver vs claim specialist overview

	Claim Approver	Claim Specialist
Yearly salary	$44,986	$43,164
Hourly rate	$21.63	$20.75
Growth rate	-6%	-6%
Number of jobs	2,918	29,505
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 54%
Average age	44	44
Years of experience	6	6

Claim approver vs claim specialist salary

Claim approvers and claim specialists have different pay scales, as shown below.

	Claim Approver	Claim Specialist
Average salary	$44,986	$43,164
Salary range	Between $31,000 And $63,000	Between $27,000 And $67,000
Highest paying City	-	Newark, NJ
Highest paying state	-	New Jersey
Best paying company	-	W. R. Berkley
Best paying industry	-	Insurance

Differences between claim approver and claim specialist education

There are a few differences between a claim approver and a claim specialist in terms of educational background:

	Claim Approver	Claim Specialist
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 54%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Claim approver vs claim specialist demographics

Here are the differences between claim approvers' and claim specialists' demographics:

	Claim Approver	Claim Specialist
Average age	44	44
Gender ratio	Male, 25.6% Female, 74.4%	Male, 31.0% Female, 69.0%
Race ratio	Black or African American, 10.5% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.5% White, 62.8% American Indian and Alaska Native, 0.5%	Black or African American, 11.4% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.1% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claim approver and claim specialist duties and responsibilities

Claim approver example responsibilities.

Manage confidential medical records and directs them to the appropriate practitioners while ensuring HIPPA regulations are maintain.
Train new hires on HMO claim processing.
Provide claim processing information for medical indemnity and PPO plans.
Present clinical management appeals for physician review and prepare provider resolution correspondence.
Submit appeals insurance follow-ups electronically, no fault, and workers compensation insurance.
Direct litigation in the areas of environmental liability, extra contractual claims, general liability, and medical malpractice.

Claim specialist example responsibilities.

Assist in the streamlining of EDI process to manage workflow of EDI claims.
Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
Manage expedition of appeals via problem solving and collaboration with other departments.

Claim approver vs claim specialist skills

Common claim approver skills

Process Claims, 24%
Medical Terminology, 23%
Disability Claims, 11%
Dental Claims, 9%
Data Entry, 5%
Insurance Claims, 4%

Common claim specialist skills

Customer Service, 19%
Litigation, 7%
Patients, 5%
Claims Handling, 4%
Quality Standards, 4%
Excellent Organizational, 4%