Post job

Explore jobs

Find specific jobs

Explore careers

Explore professions

Best companies

Explore companies

OverviewJobsSalaryResumeSkillsWhat They DoEducationCertificationsDemographicsJob DescriptionHow To HireBest CompaniesBest StatesBest CitiesRemote JobsJob Outlook

Compare

FAQsPart Time jobsEntry Level jobsFull Time jobsWork From Home jobsLocations

Claim specialist vs adjuster

The differences between claim specialists and adjusters can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 4-6 years to become a claim specialist, becoming an adjuster takes usually requires 2-4 years. Additionally, an adjuster has an average salary of $49,396, which is higher than the $43,164 average annual salary of a claim specialist.

The top three skills for a claim specialist include customer service, litigation and patients. The most important skills for an adjuster are customer service, strong customer service, and litigation.

Claim specialist vs adjuster overview

Claim SpecialistAdjuster
Yearly salary$43,164$49,396
Hourly rate$20.75$23.75
Growth rate-6%-6%
Number of jobs29,5057,936
Job satisfaction--
Most common degreeBachelor's Degree, 54%Bachelor's Degree, 62%
Average age4444
Years of experience64

What does a claim specialist do?

A claims specialist is responsible for processing insurance claims, reviewing insurance coverage, and analyzing claims cases. Claims specialists' duties include negotiating claims settlements, validating claims to prevent fraud, creating court testimonies as needed, developing claim review plans, and checking necessary documents and related resolve claims. A claims specialist must have strong analytical and critical-thinking skills to authorize claim payment and investigate complex and unusual claims. Claims specialists should also have extensive knowledge of the insurance processes to handle various cases, following legal policies and regulatory procedures.

What does an adjuster do?

An adjuster is responsible for evaluating the extent of loss in the company by calculating the damage costs, determining the settlement payment to the client, and managing the reputation of the company for claims accountability. Adjusters must have extensive knowledge of the insurance principles and processes, following the state and federal regulations to protect clients and the business from insurance fraud. They collect documents from different organizations, perform field research, and interview witnesses to verify the accuracy of claims statement.

Claim specialist vs adjuster salary

Claim specialists and adjusters have different pay scales, as shown below.

Claim SpecialistAdjuster
Average salary$43,164$49,396
Salary rangeBetween $27,000 And $67,000Between $35,000 And $68,000
Highest paying CityNewark, NJParsippany-Troy Hills, NJ
Highest paying stateNew JerseyNew Jersey
Best paying companyW. R. BerkleyFCCI
Best paying industryInsuranceInsurance

Differences between claim specialist and adjuster education

There are a few differences between a claim specialist and an adjuster in terms of educational background:

Claim SpecialistAdjuster
Most common degreeBachelor's Degree, 54%Bachelor's Degree, 62%
Most common majorBusinessBusiness
Most common collegeStanford UniversityStanford University

Claim specialist vs adjuster demographics

Here are the differences between claim specialists' and adjusters' demographics:

Claim SpecialistAdjuster
Average age4444
Gender ratioMale, 31.0% Female, 69.0%Male, 56.9% Female, 43.1%
Race ratioBlack or African American, 11.4% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.1% American Indian and Alaska Native, 0.5%Black or African American, 12.2% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.1% White, 61.4% American Indian and Alaska Native, 0.5%
LGBT Percentage10%10%

Differences between claim specialist and adjuster duties and responsibilities

Claim specialist example responsibilities.

  • Assist in the streamlining of EDI process to manage workflow of EDI claims.
  • Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
  • Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
  • Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
  • Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
  • Manage expedition of appeals via problem solving and collaboration with other departments.
    • Show more

Adjuster example responsibilities.

  • Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
  • Review evidence obtain in liability investigations to evaluate a claim for success in recovery through litigation or arbitration.
  • Document measurements and relevant data to author estimates and appraisals utilizing Xactimate 28software.
  • Charge with answering and defending policy holders and company interests through independent and binding third-party arbitration proceedings.
  • Review departmental reports and financial data; prepare reports of findings, negotiating settlement demands or recommending litigation.
  • Prepare computerize estimates utilizing Xactimate and document all activity associate with the claim in clients web base claims management system.
    • Show more

Claim specialist vs adjuster skills

Common claim specialist skills
  • Customer Service, 19%
  • Litigation, 7%
  • Patients, 5%
  • Claims Handling, 4%
  • Quality Standards, 4%
  • Excellent Organizational, 4%
Common adjuster skills
  • Customer Service, 19%
  • Strong Customer Service, 7%
  • Litigation, 7%
  • Liability Claims, 6%
  • Policy Coverage, 6%
  • Insurance Claims, 4%

Claim Specialist vs. similar jobs

Claim Specialist related careers

Claim Specialist related jobs

Claim Specialist jobs by location

Updated January 8, 2025

Browse business and financial jobs