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Claim approver vs health claims examiner

The differences between claim approvers and health claims examiners 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 health claims examiner. Additionally, a health claims examiner has an average salary of $45,220, which is higher than the $44,986 average annual salary of a claim approver.

The top three skills for a claim approver include process claims, medical terminology and disability claims. The most important skills for a health claims examiner are medical terminology, medicaid, and HMO.

Claim approver vs health claims examiner overview

Claim ApproverHealth Claims Examiner
Yearly salary$44,986$45,220
Hourly rate$21.63$21.74
Growth rate-6%-6%
Number of jobs2,91859,641
Job satisfaction--
Most common degreeBachelor's Degree, 44%Bachelor's Degree, 43%
Average age4444
Years of experience66

Claim approver vs health claims examiner salary

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

Claim ApproverHealth Claims Examiner
Average salary$44,986$45,220
Salary rangeBetween $31,000 And $63,000Between $30,000 And $67,000
Highest paying City--
Highest paying state--
Best paying company--
Best paying industry--

Differences between claim approver and health claims examiner education

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

Claim ApproverHealth Claims Examiner
Most common degreeBachelor's Degree, 44%Bachelor's Degree, 43%
Most common majorBusinessBusiness
Most common collegeUniversity of PennsylvaniaUniversity of Pennsylvania

Claim approver vs health claims examiner demographics

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

Claim ApproverHealth Claims Examiner
Average age4444
Gender ratioMale, 25.6% Female, 74.4%Male, 17.1% Female, 82.9%
Race ratioBlack 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, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 62.8% American Indian and Alaska Native, 0.5%
LGBT Percentage10%10%

Differences between claim approver and health claims examiner 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.
    • Show more

Health claims examiner example responsibilities.

  • Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
  • Review and analyze medical claims to finalize payments according to Medicaid benefits.
  • Analyze and process Medicare and Medicaid claims (Primary/Secondary).
  • Blood collection by venipuncture and capillary technique ensure all specimens are collect accurately, on time and according to establish procedures.
  • Coordinate vendor referrals for additional investigation and/or litigation management

Claim approver vs health claims examiner skills

Common claim approver skills
  • Process Claims, 24%
  • Medical Terminology, 23%
  • Disability Claims, 11%
  • Dental Claims, 9%
  • Data Entry, 5%
  • Insurance Claims, 4%
Common health claims examiner skills
  • Medical Terminology, 13%
  • Medicaid, 11%
  • HMO, 10%
  • Data Entry, 9%
  • Blood Pressure, 6%
  • Medical Claims, 5%

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Updated January 8, 2025

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