Post job

Claims adjuster vs claim specialist

The differences between claims adjusters and claim specialists 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 specialist takes usually requires 4-6 years. Additionally, a claims adjuster has an average salary of $51,116, which is higher than the $43,164 average annual salary of a claim specialist.

The top three skills for a claims adjuster include insurance carriers, auto claims and customer service. The most important skills for a claim specialist are customer service, litigation, and patients.

Claims adjuster vs claim specialist overview

Claims AdjusterClaim Specialist
Yearly salary$51,116$43,164
Hourly rate$24.57$20.75
Growth rate-6%-6%
Number of jobs13,22129,505
Job satisfaction--
Most common degreeBachelor's Degree, 66%Bachelor's Degree, 54%
Average age4444
Years of experience46

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 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.

Claims adjuster vs claim specialist salary

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

Claims AdjusterClaim Specialist
Average salary$51,116$43,164
Salary rangeBetween $40,000 And $64,000Between $27,000 And $67,000
Highest paying CityLos Angeles, CANewark, NJ
Highest paying stateNew JerseyNew Jersey
Best paying companyMerchants Insurance GroupW. R. Berkley
Best paying industryInsuranceInsurance

Differences between claims adjuster and claim specialist education

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

Claims AdjusterClaim Specialist
Most common degreeBachelor's Degree, 66%Bachelor's Degree, 54%
Most common majorBusinessBusiness
Most common collegeStanford UniversityStanford University

Claims adjuster vs claim specialist demographics

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

Claims AdjusterClaim Specialist
Average age4444
Gender ratioMale, 45.1% Female, 54.9%Male, 31.0% Female, 69.0%
Race ratioBlack 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, 11.4% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.1% American Indian and Alaska Native, 0.5%
LGBT Percentage10%10%

Differences between claims adjuster and claim specialist 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
  • Show more

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

Claims adjuster vs claim specialist skills

Common claims adjuster skills
  • Insurance Carriers, 13%
  • Auto Claims, 8%
  • Customer Service, 8%
  • Litigation, 7%
  • Xactimate, 6%
  • Claims Handling, 5%
Common claim specialist skills
  • Customer Service, 19%
  • Litigation, 7%
  • Patients, 5%
  • Claims Handling, 4%
  • Quality Standards, 4%
  • Excellent Organizational, 4%

Browse business and financial jobs