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The differences between claim specialists and reimbursement specialists 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 a reimbursement specialist takes usually requires 6-12 months. Additionally, a claim specialist has an average salary of $43,164, which is higher than the $38,273 average annual salary of a reimbursement specialist.
The top three skills for a claim specialist include customer service, litigation and patients. The most important skills for a reimbursement specialist are patients, customer service, and appeals.
| Claim Specialist | Reimbursement Specialist | |
| Yearly salary | $43,164 | $38,273 |
| Hourly rate | $20.75 | $18.40 |
| Growth rate | -6% | 11% |
| Number of jobs | 29,505 | 32,292 |
| Job satisfaction | - | - |
| Most common degree | Bachelor's Degree, 54% | Bachelor's Degree, 40% |
| Average age | 44 | 45 |
| Years of experience | 6 | 12 |
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 reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.
Claim specialists and reimbursement specialists have different pay scales, as shown below.
| Claim Specialist | Reimbursement Specialist | |
| Average salary | $43,164 | $38,273 |
| Salary range | Between $27,000 And $67,000 | Between $29,000 And $49,000 |
| Highest paying City | Newark, NJ | Lynchburg, VA |
| Highest paying state | New Jersey | Virginia |
| Best paying company | W. R. Berkley | Novartis |
| Best paying industry | Insurance | Pharmaceutical |
There are a few differences between a claim specialist and a reimbursement specialist in terms of educational background:
| Claim Specialist | Reimbursement Specialist | |
| Most common degree | Bachelor's Degree, 54% | Bachelor's Degree, 40% |
| Most common major | Business | Business |
| Most common college | Stanford University | University of Pennsylvania |
Here are the differences between claim specialists' and reimbursement specialists' demographics:
| Claim Specialist | Reimbursement Specialist | |
| Average age | 44 | 45 |
| Gender ratio | Male, 31.0% Female, 69.0% | Male, 15.2% Female, 84.8% |
| 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, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3% |
| LGBT Percentage | 10% | 9% |