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Claim auditor vs account auditor

The differences between claim auditors and account auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, an account auditor has an average salary of $76,369, which is higher than the $46,802 average annual salary of a claim auditor.

The top three skills for a claim auditor include medical terminology, medicaid and patients. The most important skills for an account auditor are audit reports, reconciliations, and CPA.

Claim auditor vs account auditor overview

Claim AuditorAccount Auditor
Yearly salary$46,802$76,369
Hourly rate$22.50$36.72
Growth rate6%6%
Number of jobs22,06889,144
Job satisfaction--
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 68%
Average age4444
Years of experience--

What does a claim auditor do?

A claims auditor is primarily in charge of processing and auditing claims in companies and other institutions, ensuring accuracy and smooth workflow. Their responsibilities include coordinating with staff to gather the necessary data, liaising with clients to identify their needs, assessing the eligibility and validity of claims, verifying payments, and maintaining records of all transactions. Furthermore, as a claims auditor, it is essential to ensure that all claims and payments are carried out in adherence to the company's policies and regulations.

What does an account auditor do?

The account auditor is the person tasked to conduct audits in sales accounts handled by the company. As with an auditor, this person checks all financial statements, investigates each entry, making sure everything is accounted for correctly. The auditor checks all receivables, attachments, and liquidation to ensure the financial report is accurate, which is vital for strategies that affect company expenses, calculate revenue, gains, and losses, and use those information to file taxes.

Claim auditor vs account auditor salary

Claim auditors and account auditors have different pay scales, as shown below.

Claim AuditorAccount Auditor
Average salary$46,802$76,369
Salary rangeBetween $34,000 And $64,000Between $53,000 And $109,000
Highest paying CitySan Francisco, CAWashington, DC
Highest paying stateWashingtonNew York
Best paying companyBerkshire HathawayApple
Best paying industryInsuranceProfessional

Differences between claim auditor and account auditor education

There are a few differences between a claim auditor and an account auditor in terms of educational background:

Claim AuditorAccount Auditor
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 68%
Most common majorBusinessAccounting
Most common collegeUniversity of PennsylvaniaUniversity of Pennsylvania

Claim auditor vs account auditor demographics

Here are the differences between claim auditors' and account auditors' demographics:

Claim AuditorAccount Auditor
Average age4444
Gender ratioMale, 23.9% Female, 76.1%Male, 39.6% Female, 60.4%
Race ratioBlack or African American, 8.6% Unknown, 4.0% Hispanic or Latino, 10.9% Asian, 12.2% White, 63.9% American Indian and Alaska Native, 0.5%Black or African American, 8.5% Unknown, 4.0% Hispanic or Latino, 10.9% Asian, 12.2% White, 64.0% American Indian and Alaska Native, 0.5%
LGBT Percentage7%7%

Differences between claim auditor and account auditor duties and responsibilities

Claim auditor example responsibilities.

  • Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
  • Bill and prepare claims appeals for Medicare, Medicaid, and private payers.
  • Review medical records and charges of hospital, ambulatory surgery and physician bills to verify CPT, ICD-9 and HCPCS codes.
  • Research and determine accuracy of ICD-9 and CPT codes on CMS 1500 and UB 92 claims forms on a daily basis.
  • Evaluate DRG grouping and pricing information.
  • Audit all claims types for a Medicare HMO plan.
    • Show more

Account auditor example responsibilities.

  • Ensure all working files and relate supporting documents meet SOX compliance and audit trail requirement
  • Work in a small team, ensure SOX compliance and GAAP/SEC/FASB reporting guidelines are adhered to.
  • Perform monthly accounting services, prepare quarterly/yearly payroll tax reports.
  • Administer processing of payroll and compliance with federal/state tax reporting requirements.
  • Review and analyze Medicaid cost report data to determine Medicaid reimbursement.
  • Verify accounts and prepares statements for private pay residents and Medicaid long-term care eligibility.
    • Show more

Claim auditor vs account auditor skills

Common claim auditor skills
  • Medical Terminology, 9%
  • Medicaid, 8%
  • Patients, 6%
  • HCPCS, 5%
  • CMS, 5%
  • Audit Findings, 5%
Common account auditor skills
  • Audit Reports, 19%
  • Reconciliations, 6%
  • CPA, 6%
  • Internal Controls, 6%
  • Audit Procedures, 6%
  • Payroll, 5%

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Updated January 8, 2025

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