Claims administrator vs insurance clerk

The differences between claims administrators and insurance clerks 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 clerk. Additionally, a claims administrator has an average salary of $36,432, which is higher than the $33,089 average annual salary of an insurance clerk.

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

Claims administrator vs insurance clerk overview

	Claims Administrator	Insurance Clerk
Yearly salary	$36,432	$33,089
Hourly rate	$17.52	$15.91
Growth rate	-3%	-3%
Number of jobs	59,006	147,755
Job satisfaction	4	2
Most common degree	Bachelor's Degree, 53%	High School Diploma, 29%
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 clerk do?

An insurance clerk usually works to process insurance, reinstatement, changes, or cancellations for a company or an individual account. They are responsible for monitoring, processing, and organizing different insurance claims for a client. They usually work closely with the company's insurance agent to provide necessary information to process the clients' application. This career requires a broad knowledge of local and state insurance policies, good attention to detail, excellent communication skills, customer service skills, and administrative skills.

Claims administrator vs insurance clerk salary

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

	Claims Administrator	Insurance Clerk
Average salary	$36,432	$33,089
Salary range	Between $29,000 And $44,000	Between $27,000 And $39,000
Highest paying City	Reno, NV	Henderson, NV
Highest paying state	Connecticut	New Hampshire
Best paying company	ABB	Lenoir Memorial Hospital
Best paying industry	Hospitality	Finance

Differences between claims administrator and insurance clerk education

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

	Claims Administrator	Insurance Clerk
Most common degree	Bachelor's Degree, 53%	High School Diploma, 29%
Most common major	Business	Business
Most common college	-	-

Claims administrator vs insurance clerk demographics

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

	Claims Administrator	Insurance Clerk
Average age	44	44
Gender ratio	Male, 28.9% Female, 71.1%	Male, 8.3% Female, 91.7%
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 clerk 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.

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Insurance clerk example responsibilities.

Manage front office check-in, insurance verification and certifications from doctors.
Establish and implement procedures for completion of patient super bills with proper diagnostic coding utilizing ICD-9 and CPT code manuals.
Maintain patient medical records insuring diagnosis codes (ICD-9) are itemized correctly and name and address of insurance carriers record.
Schedule and obtain authorization for outpatient procedures for patients via private insurance, worker's compensation, and Medicare/ Medicaid.
Complete several ICD-10 training courses.
Perform medical coding with most accurate and descriptive HCPCS code.

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Claims administrator vs insurance clerk skills

Common claims administrator skills

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

Common insurance clerk skills

Patients, 25%
Insurance Verification, 7%
Data Entry, 7%
Customer Service, 6%
Insurance Coverage, 5%
Computer System, 3%

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Updated January 8, 2025

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