Claims analyst vs adjuster

The differences between claims analysts and adjusters can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 4-6 years to become a claims analyst, becoming an adjuster takes usually requires 2-4 years. Additionally, an adjuster has an average salary of $49,396, which is higher than the $48,398 average annual salary of a claims analyst.

The top three skills for a claims analyst include customer service, medical terminology and CPT. The most important skills for an adjuster are customer service, strong customer service, and litigation.

Claims analyst vs adjuster overview

	Claims Analyst	Adjuster
Yearly salary	$48,398	$49,396
Hourly rate	$23.27	$23.75
Growth rate	-6%	-6%
Number of jobs	22,062	7,936
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 52%	Bachelor's Degree, 62%
Average age	44	44
Years of experience	6	4

What does a claims analyst do?

A claims analyst specializes in processing medical insurance claims. They are primarily responsible for verifying the authenticity and eligibility of claims, analyzing the billing, communicating with policyholders, and ensuring adherence to all the policies and regulations during the entire procedure. Furthermore, a claims analyst is also in charge of administrative tasks such as keeping and updating records, reaching out and sending reports to creditors, setting appointments and schedules, processing paperwork, coordinating with key personnel, and discussing terms and necessary information to clients.

What does an adjuster do?

An adjuster is responsible for evaluating the extent of loss in the company by calculating the damage costs, determining the settlement payment to the client, and managing the reputation of the company for claims accountability. Adjusters must have extensive knowledge of the insurance principles and processes, following the state and federal regulations to protect clients and the business from insurance fraud. They collect documents from different organizations, perform field research, and interview witnesses to verify the accuracy of claims statement.

Claims analyst vs adjuster salary

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

	Claims Analyst	Adjuster
Average salary	$48,398	$49,396
Salary range	Between $29,000 And $78,000	Between $35,000 And $68,000
Highest paying City	Trenton, NJ	Parsippany-Troy Hills, NJ
Highest paying state	New Jersey	New Jersey
Best paying company	Google	FCCI
Best paying industry	-	Insurance

Differences between claims analyst and adjuster education

There are a few differences between a claims analyst and an adjuster in terms of educational background:

	Claims Analyst	Adjuster
Most common degree	Bachelor's Degree, 52%	Bachelor's Degree, 62%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims analyst vs adjuster demographics

Here are the differences between claims analysts' and adjusters' demographics:

	Claims Analyst	Adjuster
Average age	44	44
Gender ratio	Male, 27.6% Female, 72.4%	Male, 56.9% Female, 43.1%
Race ratio	Black or African American, 11.3% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%	Black or African American, 12.2% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.1% White, 61.4% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims analyst and adjuster duties and responsibilities

Claims analyst example responsibilities.

Help managed meetings regarding decision making on CMS regulations.
Process UB's and HCFA's according to guidelines.
Analyze and investigate medical claims utilizing ICD-9 and CPT-4 coding.
Review claims (HCFA and UB) for accurate billing submission.
Interpret medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes for member submit claims.
Acquire biometrics and perform phlebotomy.

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Adjuster example responsibilities.

Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
Review evidence obtain in liability investigations to evaluate a claim for success in recovery through litigation or arbitration.
Document measurements and relevant data to author estimates and appraisals utilizing Xactimate 28software.
Charge with answering and defending policy holders and company interests through independent and binding third-party arbitration proceedings.
Review departmental reports and financial data; prepare reports of findings, negotiating settlement demands or recommending litigation.
Prepare computerize estimates utilizing Xactimate and document all activity associate with the claim in clients web base claims management system.

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Claims analyst vs adjuster skills

Common claims analyst skills

Customer Service, 14%
Medical Terminology, 5%
CPT, 5%
Process Claims, 5%
Medicaid, 5%
Data Entry, 5%

Common adjuster skills

Customer Service, 19%
Strong Customer Service, 7%
Litigation, 7%
Liability Claims, 6%
Policy Coverage, 6%
Insurance Claims, 4%

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Updated January 8, 2025

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