Claims associate vs claims representative

The differences between claims associates and claims representatives 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 representative takes usually requires 4-6 years. Additionally, a claims representative has an average salary of $38,796, 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 representative are customer service, quality standards, and policy coverage.

Claims associate vs claims representative overview

	Claims Associate	Claims Representative
Yearly salary	$36,558	$38,796
Hourly rate	$17.58	$18.65
Growth rate	-3%	-6%
Number of jobs	9,145	18,565
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 62%
Average age	44	44
Years of experience	4	6

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 representative do?

A Claims Representative is an agent who works for insurance companies in order to investigate and settle claims. The agent acts as an intermediary between customers and insurance companies by evaluating the customers' facts surrounding claims and determining whether the loss is covered or should be compensated. Such a role is important because an agent makes sure that no fraud claims are being paid out. It is also highlighted that an agent works in compliance with state regulations.

Claims associate vs claims representative salary

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

	Claims Associate	Claims Representative
Average salary	$36,558	$38,796
Salary range	Between $30,000 And $44,000	Between $28,000 And $53,000
Highest paying City	Hartford, CT	Dearborn, MI
Highest paying state	Connecticut	New Jersey
Best paying company	Accenture	W. R. Berkley
Best paying industry	Insurance	Government

Differences between claims associate and claims representative education

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

	Claims Associate	Claims Representative
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 62%
Most common major	Business	Business
Most common college	-	Stanford University

Claims associate vs claims representative demographics

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

	Claims Associate	Claims Representative
Average age	44	44
Gender ratio	Male, 30.3% Female, 69.7%	Male, 37.5% Female, 62.5%
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, 11.0% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.4% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	10%

Differences between claims associate and claims representative 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.

Claims representative example responsibilities.

Perform initial set-up and continuously manage claims in the Juris claims management system.
Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Prepare necessary state filings within statutory limits, manage litigation and vocational rehabilitation process, used appropriate cost containment techniques.
Assist the training department in developing CSR training in order to set expectations.
Create custom templates and guide sheets for new trainees in the CSR Internet division to ensure consistency and increase department efficiency.
Utilize proper SIU reporting procedures for extensive investigation as required.

Claims associate vs claims representative 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 representative skills

Customer Service, 26%
Quality Standards, 6%
Policy Coverage, 6%
Reservations, 5%
Claims Handling, 3%
Insurance Coverage, 3%

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Office and Administrative Industry
Claims Associate
Claims Associate vs Claims Representative

Updated January 8, 2025

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