Claim processor vs senior claims analyst

The differences between claim processors and senior claims analysts can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a claim processor and a senior claims analyst. Additionally, a senior claims analyst has an average salary of $79,886, which is higher than the $41,201 average annual salary of a claim processor.

The top three skills for a claim processor include customer service, data entry and medical terminology. The most important skills for a senior claims analyst are customer service, litigation, and medical terminology.

Claim processor vs senior claims analyst overview

	Claim Processor	Senior Claims Analyst
Yearly salary	$41,201	$79,886
Hourly rate	$19.81	$38.41
Growth rate	-6%	-6%
Number of jobs	11,542	21,159
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 43%	Bachelor's Degree, 61%
Average age	44	44
Years of experience	6	6

What does a claim processor do?

A Claims Processor is responsible for processing and verifying insurance claims, in adherence to the policies, laws, and regulations of the company involved. Aside from examining its authenticity, they must also oversee new policies and recommend modifications should it be needed. Moreover, it is also the task of the Claims Processor to prepare the necessary documents and guidelines for the policyholder, process reimbursements upon approval, provide answers to inquiries, and report issues and updates to the management.

What does a senior claims analyst do?

Senior Claims Analysts are responsible for providing support and oversight on the process of liability claims. Their duties include verifying submitted claims, assessing reimbursement policies, performing reconciliation with claims estimates, and conducting payment negotiations. They manage claims processing costs, prepare payment documents, reclassify entries, and attend to requestors' queries. Senior Claims Analyst also organizes records and assist in providing mentorship and training sessions to junior staff.

Claim processor vs senior claims analyst salary

Claim processors and senior claims analysts have different pay scales, as shown below.

	Claim Processor	Senior Claims Analyst
Average salary	$41,201	$79,886
Salary range	Between $26,000 And $62,000	Between $52,000 And $122,000
Highest paying City	Columbia, MD	San Leandro, CA
Highest paying state	Connecticut	Hawaii
Best paying company	NTT Data International L.L.C.	Alameda Health System
Best paying industry	Insurance	Finance

Differences between claim processor and senior claims analyst education

There are a few differences between a claim processor and a senior claims analyst in terms of educational background:

	Claim Processor	Senior Claims Analyst
Most common degree	Bachelor's Degree, 43%	Bachelor's Degree, 61%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claim processor vs senior claims analyst demographics

Here are the differences between claim processors' and senior claims analysts' demographics:

	Claim Processor	Senior Claims Analyst
Average age	44	44
Gender ratio	Male, 22.9% Female, 77.1%	Male, 30.8% Female, 69.2%
Race ratio	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 62.0% American Indian and Alaska Native, 0.5%	Black or African American, 11.3% Unknown, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 62.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claim processor and senior claims analyst duties and responsibilities

Claim processor example responsibilities.

Experience in many facets of the managed healthcare insurance business.
Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
Use ICD-9, CPT-4 and other medical manuals to adjudicate claims.
Analyze claims submit by providers and facilities for appropriate ICD-9, CPT and HCPCS codes against charges that are being bill.
Call DME and HME companies to correct invoices.
Coach and assist in the training of new EMR databases.

Senior claims analyst example responsibilities.

Accomplish facets and Macess user including running reports.
Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
Coordinate the maintenance of TPA payment type / code table conversions data.
Process claims, generate checks, create reports and correspond with TPA clients.
Review claims for correct billing information such as correct CPT codes, ICD code and patient information.
Analyze, evaluate, and conduct statistical data reviews as required by CMS in accordance with ZPIC policies.

Claim processor vs senior claims analyst skills

Common claim processor skills

Customer Service, 20%
Data Entry, 8%
Medical Terminology, 5%
CPT, 5%
Claims Processing, 4%
Medical Insurance Claims, 4%

Common senior claims analyst skills

Customer Service, 7%
Litigation, 7%
Medical Terminology, 6%
Coverage Issues, 6%
Policy Provisions, 5%
Medicaid, 5%

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Claim Processor vs Senior Claims Analyst

Updated January 8, 2025

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