Claims analyst vs senior claims representative

The differences between claims analysts and senior claims representatives 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 representative. Additionally, a senior claims representative has an average salary of $54,592, 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 representative are customer service, claims handling, and litigation.

Claims analyst vs senior claims representative overview

	Claims Analyst	Senior Claims Representative
Yearly salary	$48,398	$54,592
Hourly rate	$23.27	$26.25
Growth rate	-6%	-6%
Number of jobs	22,062	10,995
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 52%	Bachelor's Degree, 75%
Average age	44	44
Years of experience	6	6

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 representative do?

A senior claims representative serves as a client's primary point of contact when processing insurance claims. Their responsibilities include meeting with clients to identify their needs, gathering and verifying documentation, conducting investigations to determine the validity of insurance claims, liaising with external parties, and negotiating the amount of compensation. Furthermore, as a senior claims representative, it is essential to lead and serve as a mentor to junior claims representatives, all while implementing the company's policies and regulations, including its vision and mission.

Claims analyst vs senior claims representative salary

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

	Claims Analyst	Senior Claims Representative
Average salary	$48,398	$54,592
Salary range	Between $29,000 And $78,000	Between $31,000 And $94,000
Highest paying City	Trenton, NJ	-
Highest paying state	New Jersey	-
Best paying company	Google	-
Best paying industry	-	-

Differences between claims analyst and senior claims representative education

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

	Claims Analyst	Senior Claims Representative
Most common degree	Bachelor's Degree, 52%	Bachelor's Degree, 75%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims analyst vs senior claims representative demographics

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

	Claims Analyst	Senior Claims Representative
Average age	44	44
Gender ratio	Male, 27.6% Female, 72.4%	Male, 47.3% Female, 52.7%
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, 11.2% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims analyst and senior claims representative 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.

Senior claims representative example responsibilities.

Conduct detailed interviews with physicians, prepare comprehensive written reports, retain defense counsel, and effectively manage the litigation process.
Utilize Xactimate estimating system during field inspection to properly evaluate commercial property damages.
Update computer generate claim file (s) with medical diagnoses, current CPT and ICD codes.
Analyze claims using IDC and CPT coding and negotiate settlements with attorneys, claimants, medical providers, and insureds.
Set up independent medical examinations, issue denials, attend arbitration hearings.
Coordinate and attend various mediation and arbitration hearings as well as numerous settlement hearings and conferences.

Claims analyst vs senior claims representative skills

Common claims analyst skills

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

Common senior claims representative skills

Customer Service, 26%
Claims Handling, 14%
Litigation, 9%
Insurance Claims, 3%
Bodily Injury Claims, 3%
Automobile Claims, 3%

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Claims Analyst
Claims Analyst vs Senior Claims Representative

Updated January 8, 2025

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