Post job

Claims associate vs claims analyst

The differences between claims associates and claims analysts can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a claims associate, becoming a claims analyst takes usually requires 4-6 years. Additionally, a claims analyst has an average salary of $48,398, which is higher than the $36,558 average annual salary of a claims associate.

The top three skills for a claims associate include customer service, medical claims and phone calls. The most important skills for a claims analyst are customer service, medical terminology, and CPT.

Claims associate vs claims analyst overview

Claims AssociateClaims Analyst
Yearly salary$36,558$48,398
Hourly rate$17.58$23.27
Growth rate-3%-6%
Number of jobs9,14522,062
Job satisfaction--
Most common degreeBachelor's Degree, 48%Bachelor's Degree, 52%
Average age4444
Years of experience46

What does a claims associate do?

Claims associates control claims for insurance companies. Their job duties include determining a customer's insurance coverage and evaluating those who have filed a claim. Also, they must make sure that a claim is analyzed correctly for the clients to receive their entitled financial settlement. The work may require the agent to travel to generate information about the claim and may vary from a different position in the insurance industry. Qualifications for the job include an associate degree, excellent interpersonal and research skills as well as relevant experience in customer service.

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.

Claims associate vs claims analyst salary

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

Claims AssociateClaims Analyst
Average salary$36,558$48,398
Salary rangeBetween $30,000 And $44,000Between $29,000 And $78,000
Highest paying CityHartford, CTTrenton, NJ
Highest paying stateConnecticutNew Jersey
Best paying companyAccentureGoogle
Best paying industryInsurance-

Differences between claims associate and claims analyst education

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

Claims AssociateClaims Analyst
Most common degreeBachelor's Degree, 48%Bachelor's Degree, 52%
Most common majorBusinessBusiness
Most common college-Stanford University

Claims associate vs claims analyst demographics

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

Claims AssociateClaims Analyst
Average age4444
Gender ratioMale, 30.3% Female, 69.7%Male, 27.6% Female, 72.4%
Race ratioBlack 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, 11.3% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage11%10%

Differences between claims associate and claims analyst duties and responsibilities

Claims associate example responsibilities.

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Obtain vehicle information from the DMV.
  • Follow HIPAA policy on each and every call.
  • Abided by the laws and regulations associate under HIPAA and patient confidentiality.
  • Receive recognition for creating a workflow and database for all incoming subpoenas.
  • Assist in training new CSA s on job responsibilities, which increase office productivity.
  • Show more

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 associate vs claims analyst skills

Common claims associate skills
  • Customer Service, 14%
  • Medical Claims, 8%
  • Phone Calls, 8%
  • Claims Handling, 7%
  • Insurance Claims, 6%
  • Medical Terminology, 5%
Common claims analyst skills
  • Customer Service, 14%
  • Medical Terminology, 5%
  • CPT, 5%
  • Process Claims, 5%
  • Medicaid, 5%
  • Data Entry, 5%

Browse office and administrative jobs