Claims adjuster vs claim processor

The differences between claims adjusters and claim processors can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a claims adjuster, becoming a claim processor takes usually requires 4-6 years. Additionally, a claims adjuster has an average salary of $51,116, which is higher than the $41,201 average annual salary of a claim processor.

The top three skills for a claims adjuster include insurance carriers, auto claims and customer service. The most important skills for a claim processor are customer service, data entry, and medical terminology.

Claims adjuster vs claim processor overview

	Claims Adjuster	Claim Processor
Yearly salary	$51,116	$41,201
Hourly rate	$24.57	$19.81
Growth rate	-6%	-6%
Number of jobs	13,221	11,542
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 66%	Bachelor's Degree, 43%
Average age	44	44
Years of experience	4	6

What does a claims adjuster do?

A claim's adjuster is responsible for the handling of the insurance claims and investigating the extent of property damage and processing the business or a person's liability. Claims adjusters have a broad range of duties such as damage inspection to evaluate incident reports, communicating with property owners and spectators as well as referring to legal documents. They must also have excellent analytical and critical-thinking skills to calculate payments and analyze the complexities of multiple sources. Claims adjusters should also provide timely reports for reference and possible disputes.

What does a claim processor do?

A Claims Processor is responsible for processing and verifying insurance claims, in adherence to the policies, laws, and regulations of the company involved. Aside from examining its authenticity, they must also oversee new policies and recommend modifications should it be needed. Moreover, it is also the task of the Claims Processor to prepare the necessary documents and guidelines for the policyholder, process reimbursements upon approval, provide answers to inquiries, and report issues and updates to the management.

Claims adjuster vs claim processor salary

Claims adjusters and claim processors have different pay scales, as shown below.

	Claims Adjuster	Claim Processor
Average salary	$51,116	$41,201
Salary range	Between $40,000 And $64,000	Between $26,000 And $62,000
Highest paying City	Los Angeles, CA	Columbia, MD
Highest paying state	New Jersey	Connecticut
Best paying company	Merchants Insurance Group	NTT Data International L.L.C.
Best paying industry	Insurance	Insurance

Differences between claims adjuster and claim processor education

There are a few differences between a claims adjuster and a claim processor in terms of educational background:

	Claims Adjuster	Claim Processor
Most common degree	Bachelor's Degree, 66%	Bachelor's Degree, 43%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims adjuster vs claim processor demographics

Here are the differences between claims adjusters' and claim processors' demographics:

	Claims Adjuster	Claim Processor
Average age	44	44
Gender ratio	Male, 45.1% Female, 54.9%	Male, 22.9% Female, 77.1%
Race ratio	Black or African American, 11.8% Unknown, 4.4% Hispanic or Latino, 16.8% Asian, 5.2% White, 61.2% American Indian and Alaska Native, 0.5%	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 62.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims adjuster and claim processor duties and responsibilities

Claims adjuster example responsibilities.

Achieve targeted performance goals to manage costs and support Allstate's industry-leading operational standards.
Maintain a full caseload of WC files for a Louisiana customer, for six months, while managing this team.
Manage California branch operations including supervision of 5 WC adjusting and support staff
Apply strong customer service, organizational and multitasking skills to efficiently manage auto insurance claims.
Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
Manage file inventory by utilizing CCC pathways diary system documenting claim file activities in accordance with establish procedures

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Claim processor example responsibilities.

Experience in many facets of the managed healthcare insurance business.
Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
Use ICD-9, CPT-4 and other medical manuals to adjudicate claims.
Analyze claims submit by providers and facilities for appropriate ICD-9, CPT and HCPCS codes against charges that are being bill.
Call DME and HME companies to correct invoices.
Coach and assist in the training of new EMR databases.

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Claims adjuster vs claim processor skills

Common claims adjuster skills

Insurance Carriers, 13%
Auto Claims, 8%
Customer Service, 8%
Litigation, 7%
Xactimate, 6%
Claims Handling, 5%

Common claim processor skills

Customer Service, 20%
Data Entry, 8%
Medical Terminology, 5%
CPT, 5%
Claims Processing, 4%
Medical Insurance Claims, 4%

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Updated January 8, 2025

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