Post job

Claim auditor vs lead auditor

The differences between claim auditors and lead auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, a lead auditor has an average salary of $85,352, 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 a lead auditor are ISO, medicare, and management system.

Claim auditor vs lead auditor overview

Claim AuditorLead Auditor
Yearly salary$46,802$85,352
Hourly rate$22.50$41.03
Growth rate6%6%
Number of jobs22,06820,504
Job satisfaction--
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 58%
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 a lead auditor do?

Lead auditors are professionals who are responsible for providing leadership and coordinating work schedules to a team of audit experts within an organization. These lead auditors are required to prepare audit plans and conduct team meetings before conducting internal or external audits at the end of the quarter or year. They must conduct audits to provide reviews to the management about the effectiveness of the overall quality system. Lead auditors must also develop action plans to improve the financial reporting systems of the organization.

Claim auditor vs lead auditor salary

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

Claim AuditorLead Auditor
Average salary$46,802$85,352
Salary rangeBetween $34,000 And $64,000Between $62,000 And $115,000
Highest paying CitySan Francisco, CANew York, NY
Highest paying stateWashingtonNew York
Best paying companyBerkshire HathawayMeta
Best paying industryInsuranceProfessional

Differences between claim auditor and lead auditor education

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

Claim AuditorLead Auditor
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 58%
Most common majorBusinessBusiness
Most common collegeUniversity of PennsylvaniaUniversity of Pennsylvania

Claim auditor vs lead auditor demographics

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

Claim AuditorLead Auditor
Average age4444
Gender ratioMale, 23.9% Female, 76.1%Male, 57.9% Female, 42.1%
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, 8.7% Unknown, 4.0% Hispanic or Latino, 11.0% Asian, 12.2% White, 63.7% American Indian and Alaska Native, 0.5%
LGBT Percentage7%7%

Differences between claim auditor and lead 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

Lead auditor example responsibilities.

  • Manage the SOX business process implementation, execution and improvement initiatives.
  • Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
  • Enhance Sarbanes-Oxley (SOX) audit templates to provide standardization and structure that reflect current best practices while maximizing productivity.
  • Work the RMEI/RMAU reports regularly for various Medicare account types.
  • Develop exact specifications to determine why claims are not paid in accordance with specific DME Medicare guidelines.
  • Conduct surveillance and assessment of manufacturing firms, industries and companies to ensure that these systems comply with ISO standards.
  • Show more

Claim auditor vs lead auditor skills

Common claim auditor skills
  • Medical Terminology, 9%
  • Medicaid, 8%
  • Patients, 6%
  • HCPCS, 5%
  • CMS, 5%
  • Audit Findings, 5%
Common lead auditor skills
  • ISO, 16%
  • Medicare, 10%
  • Management System, 6%
  • Audit Reports, 5%
  • Corrective Action, 5%
  • Internal Controls, 4%

Browse business and financial jobs