Post job

Claims analyst vs claims manager

The differences between claims analysts and claims managers can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a claims analyst and a claims manager. Additionally, a claims manager has an average salary of $73,369, 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 a claims manager are customer service, oversight, and litigation.

Claims analyst vs claims manager overview

Claims AnalystClaims Manager
Yearly salary$48,398$73,369
Hourly rate$23.27$35.27
Growth rate-6%-6%
Number of jobs22,06230,302
Job satisfaction-5
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 66%
Average age4447
Years of experience66

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 a claims manager do?

A claims manager is an individual who works in an insurance-based firm and is responsible for managing the insurance claims department that is composed of examiners and adjusters. Claims managers are required to maintain claim files and reviewing these files as well as communicate with customers to follow up regarding issues they face with insurance claims. They must determine who is liable for the damage if there were other parties involved. Claims managers must also include an expert to assess the amount of damage and avoid insurance fraud.

Claims analyst vs claims manager salary

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

Claims AnalystClaims Manager
Average salary$48,398$73,369
Salary rangeBetween $29,000 And $78,000Between $45,000 And $117,000
Highest paying CityTrenton, NJSan Francisco, CA
Highest paying stateNew JerseyCalifornia
Best paying companyGoogleZurich
Best paying industry-Insurance

Differences between claims analyst and claims manager education

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

Claims AnalystClaims Manager
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 66%
Most common majorBusinessBusiness
Most common collegeStanford UniversityCalifornia State University - Bakersfield

Claims analyst vs claims manager demographics

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

Claims AnalystClaims Manager
Average age4447
Gender ratioMale, 27.6% Female, 72.4%Male, 47.9% Female, 52.1%
Race ratioBlack 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, 10.0% Unknown, 4.8% Hispanic or Latino, 17.1% Asian, 5.9% White, 61.5% American Indian and Alaska Native, 0.7%
LGBT Percentage10%8%

Differences between claims analyst and claims manager 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.
  • Show more

Claims manager example responsibilities.

  • Manage multiple outsource PPO networks that enable company to increase top line revenue.
  • Achieve improved structure and efficiency with initiation of pip specific unit.
  • Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
  • Oversee implementation and management of litigation and expense protocols including AFA agreements and BLO oversight.
  • Respond to all DOI questions and concerns.
  • Work with TPA, service providers and personnel on the design, implementation, and management of wellness programs.
  • Show more

Claims analyst vs claims manager skills

Common claims analyst skills
  • Customer Service, 14%
  • Medical Terminology, 5%
  • CPT, 5%
  • Process Claims, 5%
  • Medicaid, 5%
  • Data Entry, 5%
Common claims manager skills
  • Customer Service, 15%
  • Oversight, 11%
  • Litigation, 8%
  • Direct Reports, 4%
  • Claims Handling, 4%
  • Insurance Claims, 3%

Browse business and financial jobs