Claim approver vs claims adjudicator

The differences between claim approvers and claims adjudicators 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 claims adjudicator. Additionally, a claim approver has an average salary of $44,986, which is higher than the $44,556 average annual salary of a claims adjudicator.

The top three skills for a claim approver include process claims, medical terminology and disability claims. The most important skills for a claims adjudicator are medical terminology, CPT, and disability claims.

Claim approver vs claims adjudicator overview

	Claim Approver	Claims Adjudicator
Yearly salary	$44,986	$44,556
Hourly rate	$21.63	$21.42
Growth rate	-6%	-6%
Number of jobs	2,918	12,413
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 57%
Average age	44	44
Years of experience	6	6

Claim approver vs claims adjudicator salary

Claim approvers and claims adjudicators have different pay scales, as shown below.

	Claim Approver	Claims Adjudicator
Average salary	$44,986	$44,556
Salary range	Between $31,000 And $63,000	Between $31,000 And $63,000
Highest paying City	-	Madison, WI
Highest paying state	-	New Jersey
Best paying company	-	Evolent Health
Best paying industry	-	Insurance

Differences between claim approver and claims adjudicator education

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

	Claim Approver	Claims Adjudicator
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 57%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Claim approver vs claims adjudicator demographics

Here are the differences between claim approvers' and claims adjudicators' demographics:

	Claim Approver	Claims Adjudicator
Average age	44	44
Gender ratio	Male, 25.6% Female, 74.4%	Male, 23.1% Female, 76.9%
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, 10.5% Unknown, 4.5% Hispanic or Latino, 15.3% Asian, 6.1% White, 63.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claim approver and claims adjudicator 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.

Claims adjudicator example responsibilities.

Manage appeals and authorizations by examining information and performing necessary adjustments.
Handle claims processing utilizing knowledge of medical coding standards, including HCPCS, CPT, and ICD-9.
Calculate refunds or credit balances involving reprocessing for partial adjustments and correct the CPT and ICD-9 codes.
Maintain compliance with HIPAA guidelines and regulations
Adjudicate claims for Medicaid, Medicare, and ambulance billing.
Interpret and processes routine and complex claims per Medicaid industry standards.

Claim approver vs claims adjudicator skills

Common claim approver skills

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

Common claims adjudicator skills

Medical Terminology, 9%
CPT, 8%
Disability Claims, 7%
Adjudicate Claims, 6%
Quality Standards, 6%
Medicaid, 5%