Claims adjudicator vs liability claims examiner

The differences between claims adjudicators and liability claims examiners can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a claims adjudicator and a liability claims examiner. Additionally, a liability claims examiner has an average salary of $54,421, which is higher than the $44,556 average annual salary of a claims adjudicator.

The top three skills for a claims adjudicator include medical terminology, CPT and disability claims. The most important skills for a liability claims examiner are party claims, litigation, and claims handling.

Claims adjudicator vs liability claims examiner overview

	Claims Adjudicator	Liability Claims Examiner
Yearly salary	$44,556	$54,421
Hourly rate	$21.42	$26.16
Growth rate	-6%	-6%
Number of jobs	12,413	13,734
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 57%	Bachelor's Degree, 73%
Average age	44	44
Years of experience	6	6

What does a claims adjudicator do?

Claims adjudicators determine the amount of money an insurance policy owner is entitled to receive. Other names they are known for are claims adjusters and medical bill advocates. They investigate the claims filed and decide to deny, pay, or negotiate a settlement with the policyholder themselves or their representatives. The insurance companies that hire them provide insurances for property, casualty, and liability. To do their job well, they should be organized and understand how the insurance industry works.

What does a liability claims examiner do?

A Liability Claims Examiner or also known as an Insurance investigator, is a person who monitors and reviews settled insurances. They will determine if the paid amount is in accordance with the corporation or company's procedure. They report possible irregularities that are happening, like underpayment and overpayment of insurances. They also evaluate insurance claims or applications and do a follow-up of the status to protect and secure the clients from having a financial loss.

Claims adjudicator vs liability claims examiner salary

Claims adjudicators and liability claims examiners have different pay scales, as shown below.

	Claims Adjudicator	Liability Claims Examiner
Average salary	$44,556	$54,421
Salary range	Between $31,000 And $63,000	Between $34,000 And $85,000
Highest paying City	Madison, WI	Lansing, MI
Highest paying state	New Jersey	Washington
Best paying company	Evolent Health	W. R. Berkley
Best paying industry	Insurance	Insurance

Differences between claims adjudicator and liability claims examiner education

There are a few differences between a claims adjudicator and a liability claims examiner in terms of educational background:

	Claims Adjudicator	Liability Claims Examiner
Most common degree	Bachelor's Degree, 57%	Bachelor's Degree, 73%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims adjudicator vs liability claims examiner demographics

Here are the differences between claims adjudicators' and liability claims examiners' demographics:

	Claims Adjudicator	Liability Claims Examiner
Average age	44	44
Gender ratio	Male, 23.1% Female, 76.9%	Male, 46.0% Female, 54.0%
Race ratio	Black or African American, 10.5% Unknown, 4.5% Hispanic or Latino, 15.3% Asian, 6.1% White, 63.0% American Indian and Alaska Native, 0.5%	Black or African American, 11.1% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.1% White, 62.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims adjudicator and liability claims examiner duties and responsibilities

Claims adjudicator example responsibilities.

Manage appeals and authorizations by examining information and performing necessary adjustments.
Handle claims processing utilizing knowledge of medical coding standards, including HCPCS, CPT, and ICD-9.
Calculate refunds or credit balances involving reprocessing for partial adjustments and correct the CPT and ICD-9 codes.
Maintain compliance with HIPAA guidelines and regulations
Adjudicate claims for Medicaid, Medicare, and ambulance billing.
Interpret and processes routine and complex claims per Medicaid industry standards.

Liability claims examiner example responsibilities.

Handle automobile liability, general liability, products liability and manage litigation for one specific client.
Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
Oversee adjustment of all third-party liability losses, coverage assessment, investigation, and evaluations regarding litigation claims.
Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
Interact with assign counsel for case status, interrogatories and preparation for trials on calendar.
Investigate and identify fraud claims and partner with SIU for additional investigations to prevent payouts after fraud are proven.

Claims adjudicator vs liability claims examiner skills

Common claims adjudicator skills

Medical Terminology, 9%
CPT, 8%
Disability Claims, 7%
Adjudicate Claims, 6%
Quality Standards, 6%
Medicaid, 5%

Common liability claims examiner skills

Party Claims, 12%
Litigation, 12%
Claims Handling, 11%
Claims Process, 11%
Policy Coverage, 10%
Coverage Analysis, 9%

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Claims Adjudicator vs Liability Claims Examiner

Updated January 8, 2025

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