Claim auditor vs internal auditor

The differences between claim auditors and internal auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, an internal auditor has an average salary of $63,013, 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 internal auditor are CPA, risk management, and SOX.

Claim auditor vs internal auditor overview

	Claim Auditor	Internal Auditor
Yearly salary	$46,802	$63,013
Hourly rate	$22.50	$30.29
Growth rate	6%	6%
Number of jobs	22,068	25,571
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 75%
Average age	44	44
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 internal auditor do?

An internal auditor is an individual who takes responsibility for crucial accounting functions in an organization. Internal auditors have trusted consultants who advise upper management on how to handle corporate goals and risks. They review the business operations and processes of organizations. They have to assess the efficacy of the company's risk management procedures. They are expected to have superb communication skills, IT knowledge, and math aptitude. Also, they help protect the organization from potential theft and fraud of its assets.

Claim auditor vs internal auditor salary

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

	Claim Auditor	Internal Auditor
Average salary	$46,802	$63,013
Salary range	Between $34,000 And $64,000	Between $45,000 And $86,000
Highest paying City	San Francisco, CA	Washington, DC
Highest paying state	Washington	New York
Best paying company	Berkshire Hathaway	Meta
Best paying industry	Insurance	Manufacturing

Differences between claim auditor and internal auditor education

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

	Claim Auditor	Internal Auditor
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 75%
Most common major	Business	Accounting
Most common college	University of Pennsylvania	University of Pennsylvania

Claim auditor vs internal auditor demographics

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

	Claim Auditor	Internal Auditor
Average age	44	44
Gender ratio	Male, 23.9% Female, 76.1%	Male, 54.6% Female, 45.4%
Race ratio	Black 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, 8.6% Unknown, 4.0% Hispanic or Latino, 11.0% Asian, 12.9% White, 63.1% American Indian and Alaska Native, 0.5%
LGBT Percentage	7%	7%

Differences between claim auditor and internal 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.

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Internal auditor example responsibilities.

Manage and coordinate annual external business evaluation in conjunction with CPA consultants.
Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
Conduct complex performance audits, fraud investigations, special projects and routine follow-up reviews in accordance with IIA standards.
Perform tests of critical controls in compliance with Sarbanes-Oxley legislation and report results utilizing company compliance tool to validate SOX checklist.
Develop company FDA policy & procedures for liquid oxygen small bulk delivery vessels.
Perform planning, compliance testing, substantive analysis and testing in accordance with GAAS.

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Claim auditor vs internal auditor skills

Common claim auditor skills

Medical Terminology, 9%
Medicaid, 8%
Patients, 6%
HCPCS, 5%
CMS, 5%
Audit Findings, 5%

Common internal auditor skills

CPA, 8%
Risk Management, 5%
SOX, 5%
Audit Findings, 5%
Audit Procedures, 5%
Internal Audit Function, 5%

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Updated January 8, 2025

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