Claim auditor vs revenue auditor

The differences between claim auditors and revenue auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, a claim auditor has an average salary of $46,802, which is higher than the $41,905 average annual salary of a revenue auditor.

The top three skills for a claim auditor include medical terminology, medicaid and patients. The most important skills for a revenue auditor are revenue audit, CPT, and audit procedures.

Claim auditor vs revenue auditor overview

	Claim Auditor	Revenue Auditor
Yearly salary	$46,802	$41,905
Hourly rate	$22.50	$20.15
Growth rate	6%	6%
Number of jobs	22,068	21,643
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 53%
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 a revenue auditor do?

A revenue auditor reads through the organization's finances and records revenue derived from the sale of goods and services. They then create reports indicating all their calculations and recommendations to ensure the organization runs effectively and makes a profit. Their duties and responsibilities include preparing a detailed report on the organization's finances and offering recommendations. Auditors also report cases of fraud or misuse of funds.

Claim auditor vs revenue auditor salary

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

	Claim Auditor	Revenue Auditor
Average salary	$46,802	$41,905
Salary range	Between $34,000 And $64,000	Between $26,000 And $66,000
Highest paying City	San Francisco, CA	Olympia, WA
Highest paying state	Washington	Washington
Best paying company	Berkshire Hathaway	Huntington Hospital
Best paying industry	Insurance	Retail

Differences between claim auditor and revenue auditor education

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

	Claim Auditor	Revenue Auditor
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 53%
Most common major	Business	Accounting
Most common college	University of Pennsylvania	University of Pennsylvania

Claim auditor vs revenue auditor demographics

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

	Claim Auditor	Revenue Auditor
Average age	44	44
Gender ratio	Male, 23.9% Female, 76.1%	Male, 39.4% Female, 60.6%
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, 8.5% Unknown, 4.0% Hispanic or Latino, 10.8% Asian, 12.2% White, 64.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	7%	7%

Differences between claim auditor and revenue 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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Revenue auditor example responsibilities.

Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
Respond both written and oral to taxpayer's appeals regardingadjustments and assessments to their income tax returns and/or estimate tax accounts.
Work with revenue integrity, case management, and coding to ensure proper billing and appeals.
Perform audits on hospitals participating in Medicaid program to ensure the hospitals are reimburse properly for services render to Medicaid beneficiaries.
Develop user documentation, including SAAS reference manuals and training material.

Claim auditor vs revenue auditor skills

Common claim auditor skills

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

Common revenue auditor skills

Revenue Audit, 19%
CPT, 7%
Audit Procedures, 5%
Data Entry, 5%
Appeals, 4%
Financial Statements, 4%

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Updated January 8, 2025

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