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Claim auditor vs auditor

The differences between claim auditors and auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, an auditor has an average salary of $54,853, 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 auditor are audit reports, customer service, and financial statements.

Claim auditor vs auditor overview

Claim AuditorAuditor
Yearly salary$46,802$54,853
Hourly rate$22.50$26.37
Growth rate6%6%
Number of jobs22,06820,325
Job satisfaction-3
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 55%
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 auditor do?

An auditor is responsible for reviewing financial statements and making sure that the reports align with the accounting principles and legislative standards. Some of the important duties of an auditor are verifying the company's account statements, ensuring that the business is free from fraud and other unusual activities, providing recommendations to boost operations' performance, and creating financial reports for the board. An auditor should have excellent analytical and decision-making skills to spot inaccuracies of financial statements and resolve financial issues immediately.

Claim auditor vs auditor salary

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

Claim AuditorAuditor
Average salary$46,802$54,853
Salary rangeBetween $34,000 And $64,000Between $35,000 And $84,000
Highest paying CitySan Francisco, CAWashington, DC
Highest paying stateWashingtonNew Jersey
Best paying companyBerkshire HathawayMicrosoft
Best paying industryInsuranceProfessional

Differences between claim auditor and auditor education

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

Claim AuditorAuditor
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 55%
Most common majorBusinessAccounting
Most common collegeUniversity of PennsylvaniaUniversity of Pennsylvania

Claim auditor vs auditor demographics

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

Claim AuditorAuditor
Average age4444
Gender ratioMale, 23.9% Female, 76.1%Male, 44.9% Female, 55.1%
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, 8.8% Unknown, 4.0% Hispanic or Latino, 11.1% Asian, 12.1% White, 63.5% American Indian and Alaska Native, 0.5%
LGBT Percentage7%7%

Differences between claim auditor and 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

Auditor example responsibilities.

  • Lead FDA readiness audits and participate in regulatory inspections.
  • Manage the collection, analysis and verification of managerial payroll information to detect fraud and/or unethical practices.
  • Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
  • Perform semi-annual financial audits w/ externally contract CPA to validate accounts payable and receivables.
  • Develop and facilitate training for SOX process owners and other stakeholders using Microsoft PowerPoint.
  • Work efficiently and effectively with various process owners to develop SOX specific business processes and mating documentation controls.
    • Show more

Claim auditor vs auditor skills

Common claim auditor skills
  • Medical Terminology, 9%
  • Medicaid, 8%
  • Patients, 6%
  • HCPCS, 5%
  • CMS, 5%
  • Audit Findings, 5%
Common auditor skills
  • Audit Reports, 18%
  • Customer Service, 8%
  • Financial Statements, 6%
  • Audit Findings, 5%
  • Audit Procedures, 5%
  • Payroll, 5%

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Updated January 8, 2025

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