Claims assistant vs medical claims processor

The differences between claims assistants and medical claims processors 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 assistant and a medical claims processor. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $36,487 average annual salary of a claims assistant.

The top three skills for a claims assistant include customer service, data entry and photocopying. The most important skills for a medical claims processor are patients, healthcare, and data entry.

Claims assistant vs medical claims processor overview

	Claims Assistant	Medical Claims Processor
Yearly salary	$36,487	$36,777
Hourly rate	$17.54	$17.68
Growth rate	-3%	-3%
Number of jobs	8,971	59,992
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 43%	Bachelor's Degree, 29%
Average age	44	44
Years of experience	4	4

What does a claims assistant do?

A claims assistant takes tasks to support staff in processing insurance claims. Claims assistants manage correspondence, take phone calls, do paperwork, and type documents. Also called insurance claim clerks, the assistants do clerical and administrative tasks. They assist professionals working for financial services enterprises, medical providers, and insurance enterprises. Among the skills they need are strong communication skills, data entry, customer service, attention to detail, and knowledge about insurance. They are also expected to have management skills.

What does a medical claims processor do?

A medical claims processor has working knowledge of medical billing and coding. The qualifications for this position include knowledge of current procedural terminology (CPT) and international classification of diseases (ICD) coding systems. They are responsible for processing claims forms, adjudicating the allocation of deductibles and copays, and following through with adjudication policies to facilitate proper payment of claims.

Claims assistant vs medical claims processor salary

Claims assistants and medical claims processors have different pay scales, as shown below.

	Claims Assistant	Medical Claims Processor
Average salary	$36,487	$36,777
Salary range	Between $30,000 And $44,000	Between $29,000 And $45,000
Highest paying City	Hartford, CT	Dover, DE
Highest paying state	Connecticut	Delaware
Best paying company	National General Insurance	Cognizant
Best paying industry	Government	Government

Differences between claims assistant and medical claims processor education

There are a few differences between a claims assistant and a medical claims processor in terms of educational background:

	Claims Assistant	Medical Claims Processor
Most common degree	Bachelor's Degree, 43%	Bachelor's Degree, 29%
Most common major	Business	Business
Most common college	-	-

Claims assistant vs medical claims processor demographics

Here are the differences between claims assistants' and medical claims processors' demographics:

	Claims Assistant	Medical Claims Processor
Average age	44	44
Gender ratio	Male, 19.5% Female, 80.5%	Male, 16.0% Female, 84.0%
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 assistant and medical claims processor duties and responsibilities

Claims assistant example responsibilities.

Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
Process all HMO member reimbursements.
Create and provide weekly/monthly reports and PowerPoint presentations.
Coordinate daily operations such as updating litigation calendars and client data files.
Maintain a diary of complex, high dollar exposure, politically sensitive and high-visibility litigation claims.
Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.

Medical claims processor example responsibilities.

Enter UB 92 and 1500 HCFA medical claims into computer system manage and process insurance claims.
Manage cases by aggressively directing the litigation process.
Submit medical claims to commercial insurance companies, Medicare, and Medicaid for payment with use of ICD-9 and CPT coding.
Review and verify patient account information against insurance program specifications, analyze surgical procedures and diagnoses using CPT-4 and ICD-9 codes.
Acknowledge and enforces confidentiality in alignment with (HIPPA) guidelines.
Audit encounters and ICD-10 codes to ensure correct coding and maximum reimbursement.

Claims assistant vs medical claims processor skills

Common claims assistant skills

Customer Service, 23%
Data Entry, 12%
Photocopying, 6%
Insurance Claims, 5%
Insurance Adjusters, 5%
Veterans, 4%

Common medical claims processor skills

Patients, 13%
Healthcare, 10%
Data Entry, 10%
Medical Insurance Claims, 9%
Medical Terminology, 6%
Customer Service, 3%

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Claims Assistant
Claims Assistant vs Medical Claims Processor

Updated January 8, 2025

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