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Claim specialist vs specialist

The differences between claim specialists and 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 specialist takes usually requires 1-2 years. Additionally, a specialist has an average salary of $58,013, 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 specialist are patients, customer service, and work ethic.

Claim specialist vs specialist overview

Claim SpecialistSpecialist
Yearly salary$43,164$58,013
Hourly rate$20.75$27.89
Growth rate-6%10%
Number of jobs29,505358,433
Job satisfaction--
Most common degreeBachelor's Degree, 54%Bachelor's Degree, 49%
Average age4442
Years of experience62

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 a specialist do?

Specialists are employees who are responsible for specific tasks or activities in the department they are assigned to. The actions or tasks they work on are related to their educational background or work experiences. They are usually highly skilled in specializations related to the work they are assigned to. Specialists are also highly trained on the competencies that are required of their specialty. As such, they are focused on the skills and competencies that are needed to enhance their experience in their specific field further.

Claim specialist vs specialist salary

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

Claim SpecialistSpecialist
Average salary$43,164$58,013
Salary rangeBetween $27,000 And $67,000Between $32,000 And $104,000
Highest paying CityNewark, NJJersey City, NJ
Highest paying stateNew JerseyNew Jersey
Best paying companyW. R. BerkleyThe Citadel
Best paying industryInsurance-

Differences between claim specialist and specialist education

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

Claim SpecialistSpecialist
Most common degreeBachelor's Degree, 54%Bachelor's Degree, 49%
Most common majorBusinessBusiness
Most common collegeStanford UniversityStanford University

Claim specialist vs specialist demographics

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

Claim SpecialistSpecialist
Average age4442
Gender ratioMale, 31.0% Female, 69.0%Male, 47.5% Female, 52.5%
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, 11.4% Unknown, 5.4% Hispanic or Latino, 16.4% Asian, 10.5% White, 55.9% American Indian and Alaska Native, 0.4%
LGBT Percentage10%11%

Differences between claim specialist and specialist 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

Specialist example responsibilities.

  • Create, manage, and assist users with SharePoint sites.
  • Manage an on-site IRB and company good clinical practice (GCP) inspection.
  • Manage SharePoint sites by creating, editing, and customizing company sites, libraries and security.
  • Manage the building of accounts, assigning of static IP's, and scheduling of business class installations.
  • Convert servers from UNIX to Linux, all hardware diagnostics and repair including printers/plotters/desktops etc.
  • Follow safety procedures such as maintenance of all equipment (Telxon scanners, terminals and ladders).
  • Show more

Claim specialist vs specialist skills

Common claim specialist skills
  • Customer Service, 19%
  • Litigation, 7%
  • Patients, 5%
  • Claims Handling, 4%
  • Quality Standards, 4%
  • Excellent Organizational, 4%
Common specialist skills
  • Patients, 15%
  • Customer Service, 11%
  • Work Ethic, 5%
  • Patient Care, 4%
  • Exceptional Client, 4%
  • Troubleshoot, 4%

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