Claims administrator vs insurance claims processor

The differences between claims administrators and insurance claims processors 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 claims processor. Additionally, an insurance claims processor has an average salary of $37,151, which is higher than the $36,432 average annual salary of a claims administrator.

The top three skills for a claims administrator include data entry, customer service and process claims. The most important skills for an insurance claims processor are data entry, customer service, and medicaid.

Claims administrator vs insurance claims processor overview

	Claims Administrator	Insurance Claims Processor
Yearly salary	$36,432	$37,151
Hourly rate	$17.52	$17.86
Growth rate	-3%	-3%
Number of jobs	59,006	48,777
Job satisfaction	4	-
Most common degree	Bachelor's Degree, 53%	Bachelor's Degree, 30%
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 claims processor do?

A claims processor usually works in health or property insurance claims. They are responsible for processing and evaluating the claim forms, monitoring and verifying information, and closely communicating with the company's clients, beneficiaries, and agents. Also, they handle queries and comments, calculate possible claims, and process of various payments. They also need to ensure all insurance company guidelines and policies are adhered to in order to avoid discrepancies, issues, and other problems regarding a client's claims.

Claims administrator vs insurance claims processor salary

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

	Claims Administrator	Insurance Claims Processor
Average salary	$36,432	$37,151
Salary range	Between $29,000 And $44,000	Between $30,000 And $45,000
Highest paying City	Reno, NV	Eden Prairie, MN
Highest paying state	Connecticut	Connecticut
Best paying company	ABB	Accenture
Best paying industry	Hospitality	Insurance

Differences between claims administrator and insurance claims processor education

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

	Claims Administrator	Insurance Claims Processor
Most common degree	Bachelor's Degree, 53%	Bachelor's Degree, 30%
Most common major	Business	Business
Most common college	-	-

Claims administrator vs insurance claims processor demographics

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

	Claims Administrator	Insurance Claims Processor
Average age	44	44
Gender ratio	Male, 28.9% Female, 71.1%	Male, 20.3% Female, 79.7%
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 claims processor 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 claims processor example responsibilities.

Manage cases by aggressively directing the litigation process.
Maintain confidentiality in accordance with HIPAA laws.
Process ICD-9 codes, diagnostic and procedure codes.
Handle confidential information according to HIPPA and JAACHO standards.
Follow and comply with HIPPA rules and regulations to ensure patient privacy.
Process medical and dental claims using appropriate CPT, ICD-9, and ADA coding.

Claims administrator vs insurance claims processor skills

Common claims administrator skills

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

Common insurance claims processor skills

Data Entry, 18%
Customer Service, 11%
Medicaid, 8%
Medical Terminology, 6%
Insurance Coverage, 5%
ICD-9, 4%

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Claims Administrator
Claims Administrator vs Insurance Claims Processor

Updated January 8, 2025

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