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Claims analyst vs senior claims examiner

The differences between claims analysts and senior claims examiners 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 senior claims examiner. Additionally, a senior claims examiner has an average salary of $50,962, 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 senior claims examiner are customer service, litigation, and property damage.

Claims analyst vs senior claims examiner overview

Claims AnalystSenior Claims Examiner
Yearly salary$48,398$50,962
Hourly rate$23.27$24.50
Growth rate-6%-6%
Number of jobs22,06210,931
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 58%
Average age4444
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 senior claims examiner do?

Senior claims examiners review, assess, and process the insurance claims of their clients. The examiners provide recommendations for claims-related resolution. It is their responsibility to examine and authorize the investigation of insurance claims as conducted by insurance adjusters. They check the claims and the insurance policies to ensure that all the information is right. During the settlement, they are expected to be careful in keeping the records with details of the process.

Claims analyst vs senior claims examiner salary

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

Claims AnalystSenior Claims Examiner
Average salary$48,398$50,962
Salary rangeBetween $29,000 And $78,000Between $34,000 And $75,000
Highest paying CityTrenton, NJUrban Honolulu, HI
Highest paying stateNew JerseyHawaii
Best paying companyGoogleW. R. Berkley
Best paying industry-Finance

Differences between claims analyst and senior claims examiner education

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

Claims AnalystSenior Claims Examiner
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 58%
Most common majorBusinessBusiness
Most common collegeStanford UniversityStanford University

Claims analyst vs senior claims examiner demographics

Here are the differences between claims analysts' and senior claims examiners' demographics:

Claims AnalystSenior Claims Examiner
Average age4444
Gender ratioMale, 27.6% Female, 72.4%Male, 29.6% Female, 70.4%
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, 10.8% Unknown, 4.4% Hispanic or Latino, 16.8% Asian, 5.2% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage10%10%

Differences between claims analyst and senior claims examiner 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

Senior claims examiner example responsibilities.

  • Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
  • Coordinate vendor referrals for additional investigation and/or litigation management
  • Maintain office records of various types of complaints, conciliation, administrative decision, private litigation resolution, gather detailed information.
  • Ensure all HIPPA regulations are followed in the creation and release of all confidential records.
  • Coordinate vendor referrals for additional investigation and/or litigation management

Claims analyst vs senior claims examiner skills

Common claims analyst skills
  • Customer Service, 14%
  • Medical Terminology, 5%
  • CPT, 5%
  • Process Claims, 5%
  • Medicaid, 5%
  • Data Entry, 5%
Common senior claims examiner skills
  • Customer Service, 21%
  • Litigation, 11%
  • Property Damage, 9%
  • Claims Handling, 6%
  • TPA, 4%
  • Coverage Issues, 4%

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