Claims administrator vs insurance biller

The differences between claims administrators and insurance billers can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both a claims administrator and an insurance biller. Additionally, a claims administrator has an average salary of $36,432, which is higher than the $35,822 average annual salary of an insurance biller.

The top three skills for a claims administrator include data entry, customer service and process claims. The most important skills for an insurance biller are patients, medical terminology, and CPT.

Claims administrator vs insurance biller overview

	Claims Administrator	Insurance Biller
Yearly salary	$36,432	$35,822
Hourly rate	$17.52	$17.22
Growth rate	-3%	-3%
Number of jobs	59,006	84,361
Job satisfaction	4	-
Most common degree	Bachelor's Degree, 53%	High School Diploma, 26%
Average age	44	44
Years of experience	4	4

What does a claims administrator do?

Claims administrators are professionals who are responsible for performing administrative duties related to insurance claims. These administrators must collaborate with insurance companies so that they can analyze claims and determine the extent of the company's liability. They must review billing and process claims correctly by identifying provider information and other documentation to ensure a prompt payout. Claims administrators must also maintain and manage the compensation files of all workers in order to conduct preliminary investigations on work-related injuries for worker's compensation claims.

What does an insurance biller do?

An insurance biller is responsible for making daily reviews and processing documents concerning the insurance payment and bills of a client. They assess if all requirements are correct and complete, obtain different referrals and authorization papers, and prepare and transmit document claims using a particular software. Also, they do follow ups regarding unpaid claims and update spreadsheets for record purposes.

Claims administrator vs insurance biller salary

Claims administrators and insurance billers have different pay scales, as shown below.

	Claims Administrator	Insurance Biller
Average salary	$36,432	$35,822
Salary range	Between $29,000 And $44,000	Between $28,000 And $44,000
Highest paying City	Reno, NV	-
Highest paying state	Connecticut	-
Best paying company	ABB	-
Best paying industry	Hospitality	-

Differences between claims administrator and insurance biller education

There are a few differences between a claims administrator and an insurance biller in terms of educational background:

	Claims Administrator	Insurance Biller
Most common degree	Bachelor's Degree, 53%	High School Diploma, 26%
Most common major	Business	Business
Most common college	-	-

Claims administrator vs insurance biller demographics

Here are the differences between claims administrators' and insurance billers' demographics:

	Claims Administrator	Insurance Biller
Average age	44	44
Gender ratio	Male, 28.9% Female, 71.1%	Male, 6.9% Female, 93.1%
Race ratio	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	11%

Differences between claims administrator and insurance biller duties and responsibilities

Claims administrator example responsibilities.

Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
Implement HIPAA regulations to protect patient privacy.
Adjudicate medical, commercial and Medicaid, claims.
Code medical records by following current ICD-9/ICD-10, CPT, and HCPCS standards.
Work with doctors, TPA, adjusters, attorneys, to maintain claim cost effectively.
Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.

Insurance biller example responsibilities.

Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
Utilize ICD-9 and CPT codes, enter charges, and send statements for billing purposes.
Process monetary transactions, insurance payments and enter into bookkeeping ledgers and monthly statements to patients.
Submit medical claims for reimbursement on medical services provide to patients by medical provider for reimbursement.
Code and post hospital and office charges using ICD-9, CPT-4.
Look up ICD-9 codes to verify if a code has been change and enter.

Claims administrator vs insurance biller skills

Common claims administrator skills

Data Entry, 12%
Customer Service, 9%
Process Claims, 8%
Phone Calls, 7%
HR, 5%
Insurance Claims, 5%

Common insurance biller skills

Patients, 15%
Medical Terminology, 10%
CPT, 8%
Medi-Cal, 6%
Data Entry, 5%
Insurance Claims, 5%

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Office and Administrative Industry
Claims Administrator
Claims Administrator vs Insurance Biller

Updated January 8, 2025

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