Claims associate vs insurance claims processor

The differences between claims associates and insurance 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 associate and an insurance claims processor. Additionally, an insurance claims processor has an average salary of $37,151, 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 an insurance claims processor are data entry, customer service, and medicaid.

Claims associate vs insurance claims processor overview

	Claims Associate	Insurance Claims Processor
Yearly salary	$36,558	$37,151
Hourly rate	$17.58	$17.86
Growth rate	-3%	-3%
Number of jobs	9,145	48,777
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 30%
Average age	44	44
Years of experience	4	4

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 an insurance claims processor do?

A claims processor usually works in health or property insurance claims. They are responsible for processing and evaluating the claim forms, monitoring and verifying information, and closely communicating with the company's clients, beneficiaries, and agents. Also, they handle queries and comments, calculate possible claims, and process of various payments. They also need to ensure all insurance company guidelines and policies are adhered to in order to avoid discrepancies, issues, and other problems regarding a client's claims.

Claims associate vs insurance claims processor salary

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

	Claims Associate	Insurance Claims Processor
Average salary	$36,558	$37,151
Salary range	Between $30,000 And $44,000	Between $30,000 And $45,000
Highest paying City	Hartford, CT	Eden Prairie, MN
Highest paying state	Connecticut	Connecticut
Best paying company	Accenture	Accenture
Best paying industry	Insurance	Insurance

Differences between claims associate and insurance claims processor education

There are a few differences between a claims associate and an insurance claims processor in terms of educational background:

	Claims Associate	Insurance Claims Processor
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 30%
Most common major	Business	Business
Most common college	-	-

Claims associate vs insurance claims processor demographics

Here are the differences between claims associates' and insurance claims processors' demographics:

	Claims Associate	Insurance Claims Processor
Average age	44	44
Gender ratio	Male, 30.3% Female, 69.7%	Male, 20.3% Female, 79.7%
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 associate and insurance claims processor 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.

Insurance claims processor example responsibilities.

Manage cases by aggressively directing the litigation process.
Maintain confidentiality in accordance with HIPAA laws.
Process ICD-9 codes, diagnostic and procedure codes.
Handle confidential information according to HIPPA and JAACHO standards.
Follow and comply with HIPPA rules and regulations to ensure patient privacy.
Process medical and dental claims using appropriate CPT, ICD-9, and ADA coding.

Claims associate vs insurance claims processor skills

Common claims associate skills

Customer Service, 14%
Medical Claims, 8%
Phone Calls, 8%
Claims Handling, 7%
Insurance Claims, 6%
Medical Terminology, 5%

Common insurance claims processor skills

Data Entry, 18%
Customer Service, 11%
Medicaid, 8%
Medical Terminology, 6%
Insurance Coverage, 5%
ICD-9, 4%

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Office and Administrative Industry
Claims Associate
Claims Associate vs Insurance Claims Processor

Updated January 8, 2025

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