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The differences between claim specialists and 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 specialist and a claims analyst. Additionally, a claims analyst has an average salary of $48,398, 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 a claims analyst are customer service, medical terminology, and CPT.
| Claim Specialist | Claims Analyst | |
| Yearly salary | $43,164 | $48,398 |
| Hourly rate | $20.75 | $23.27 |
| Growth rate | -6% | -6% |
| Number of jobs | 29,505 | 22,062 |
| Job satisfaction | - | - |
| Most common degree | Bachelor's Degree, 54% | Bachelor's Degree, 52% |
| Average age | 44 | 44 |
| Years of experience | 6 | 6 |
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.
A claims analyst specializes in processing medical insurance claims. They are primarily responsible for verifying the authenticity and eligibility of claims, analyzing the billing, communicating with policyholders, and ensuring adherence to all the policies and regulations during the entire procedure. Furthermore, a claims analyst is also in charge of administrative tasks such as keeping and updating records, reaching out and sending reports to creditors, setting appointments and schedules, processing paperwork, coordinating with key personnel, and discussing terms and necessary information to clients.
Claim specialists and claims analysts have different pay scales, as shown below.
| Claim Specialist | Claims Analyst | |
| Average salary | $43,164 | $48,398 |
| Salary range | Between $27,000 And $67,000 | Between $29,000 And $78,000 |
| Highest paying City | Newark, NJ | Trenton, NJ |
| Highest paying state | New Jersey | New Jersey |
| Best paying company | W. R. Berkley | |
| Best paying industry | Insurance | - |
There are a few differences between a claim specialist and a claims analyst in terms of educational background:
| Claim Specialist | Claims Analyst | |
| Most common degree | Bachelor's Degree, 54% | Bachelor's Degree, 52% |
| Most common major | Business | Business |
| Most common college | Stanford University | Stanford University |
Here are the differences between claim specialists' and claims analysts' demographics:
| Claim Specialist | Claims Analyst | |
| Average age | 44 | 44 |
| Gender ratio | Male, 31.0% Female, 69.0% | Male, 27.6% Female, 72.4% |
| Race ratio | Black 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, 11.3% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5% |
| LGBT Percentage | 10% | 10% |