Claim auditor vs staff auditor

The differences between claim auditors and staff auditors can be seen in a few details. Each job has different responsibilities and duties. Additionally, a staff auditor has an average salary of $55,431, 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 staff auditor are audit procedures, CPA, and internal audit.

Claim auditor vs staff auditor overview

	Claim Auditor	Staff Auditor
Yearly salary	$46,802	$55,431
Hourly rate	$22.50	$26.65
Growth rate	6%	6%
Number of jobs	22,068	91,268
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 82%
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 staff auditor do?

The duties of a staff auditor depend on their line of work or place of employment. Typically, their responsibilities revolve around conducting financial audits and operational analysis to determine efficiency and compliance to regulations, coordinating with different departments to gather data, reach out to clients through calls or correspondence, and arrange appointments when necessary. A staff auditor may also perform clerical tasks such as produce progress reports, create presentations, respond to inquiries and concerns, and maintain extensive records and data.

Claim auditor vs staff auditor salary

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

	Claim Auditor	Staff Auditor
Average salary	$46,802	$55,431
Salary range	Between $34,000 And $64,000	Between $43,000 And $70,000
Highest paying City	San Francisco, CA	Washington, DC
Highest paying state	Washington	Alaska
Best paying company	Berkshire Hathaway	Signature Bank
Best paying industry	Insurance	Professional

Differences between claim auditor and staff auditor education

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

	Claim Auditor	Staff Auditor
Most common degree	Bachelor's Degree, 45%	Bachelor's Degree, 82%
Most common major	Business	Accounting
Most common college	University of Pennsylvania	University of Pennsylvania

Claim auditor vs staff auditor demographics

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

	Claim Auditor	Staff Auditor
Average age	44	44
Gender ratio	Male, 23.9% Female, 76.1%	Male, 59.3% Female, 40.7%
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, 8.7% Unknown, 4.0% Hispanic or Latino, 11.0% Asian, 13.3% White, 62.5% American Indian and Alaska Native, 0.5%
LGBT Percentage	7%	7%

Differences between claim auditor and staff 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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Staff auditor example responsibilities.

Manage accounting operations, accounting close, account reporting and reconciliations for internal corporate and bank transactions.
Review consolidated GAAP financial statements, inter-company eliminations and fluctuations between budget verses actual results.
Ensure engagements are in compliance with generally accept accounting principles (GAAP) and generally accept auditing standards (GAAS).
Conduct financial audits in accordance with GAAS to establish compliance with policies and procedures and to determine effectiveness of internal controls.
Collaborate closely with clients by educating them on new opportunities and conduct tax research and planning; train clients on QuickBooks.
Collaborate with the quality department in authoring ISO procedures for manufacturing engineering; key contributor on quality and ISO auditing teams.

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Claim auditor vs staff auditor skills

Common claim auditor skills

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

Common staff auditor skills

Audit Procedures, 12%
CPA, 12%
Internal Audit, 7%
Audit Reports, 5%
Audit Findings, 5%
Compliance Audits, 4%

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Updated January 8, 2025

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