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Claims clerk vs claims administrator

The differences between claims clerks and claims administrators 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 clerk and a claims administrator. Additionally, a claims administrator has an average salary of $36,432, which is higher than the $32,815 average annual salary of a claims clerk.

The top three skills for a claims clerk include data entry, customer service and clerical support. The most important skills for a claims administrator are data entry, customer service, and process claims.

Claims clerk vs claims administrator overview

Claims ClerkClaims Administrator
Yearly salary$32,815$36,432
Hourly rate$15.78$17.52
Growth rate-3%-3%
Number of jobs78,58859,006
Job satisfaction-4
Most common degreeBachelor's Degree, 31%Bachelor's Degree, 53%
Average age4444
Years of experience44

What does a claims clerk do?

Claims clerks review the forms and documents for insurance claims to check for missing information and attachments. The data they obtain is entered into their database for safekeeping and quick retrieval. They should know the answers to their clients' questions about the regulations, policies, and procedures covered by their insurance policy. These clerks prepare documents that their agents use to present to their clients. When working for this position, a person must have the ability to communicate well and be familiar with computer applications.

What does a claims administrator do?

Claims administrators are professionals who are responsible for performing administrative duties related to insurance claims. These administrators must collaborate with insurance companies so that they can analyze claims and determine the extent of the company's liability. They must review billing and process claims correctly by identifying provider information and other documentation to ensure a prompt payout. Claims administrators must also maintain and manage the compensation files of all workers in order to conduct preliminary investigations on work-related injuries for worker's compensation claims.

Claims clerk vs claims administrator salary

Claims clerks and claims administrators have different pay scales, as shown below.

Claims ClerkClaims Administrator
Average salary$32,815$36,432
Salary rangeBetween $27,000 And $39,000Between $29,000 And $44,000
Highest paying City-Reno, NV
Highest paying state-Connecticut
Best paying company-ABB
Best paying industry-Hospitality

Differences between claims clerk and claims administrator education

There are a few differences between a claims clerk and a claims administrator in terms of educational background:

Claims ClerkClaims Administrator
Most common degreeBachelor's Degree, 31%Bachelor's Degree, 53%
Most common majorBusinessBusiness
Most common college--

Claims clerk vs claims administrator demographics

Here are the differences between claims clerks' and claims administrators' demographics:

Claims ClerkClaims Administrator
Average age4444
Gender ratioMale, 17.5% Female, 82.5%Male, 28.9% Female, 71.1%
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, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage11%11%

Differences between claims clerk and claims administrator duties and responsibilities

Claims clerk example responsibilities.

  • Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
  • File commercial, worker's comp, Medicare, and Medicaid claims to insurance carriers and employers.
  • Open and sort mail by claim types (HCPA UB 92 and T18).
  • Process medical HMO claims, POS claims, PPO claims and fee for service claims.
  • Review, scan, and file HCFA forms
  • Audit paper claims for accuracy in CPT and ICD9 codes.
    • Show more

Claims administrator example responsibilities.

  • Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
  • Implement HIPAA regulations to protect patient privacy.
  • Adjudicate medical, commercial and Medicaid, claims.
  • Code medical records by following current ICD-9/ICD-10, CPT, and HCPCS standards.
  • Work with doctors, TPA, adjusters, attorneys, to maintain claim cost effectively.
  • Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.
    • Show more

Claims clerk vs claims administrator skills

Common claims clerk skills
  • Data Entry, 26%
  • Customer Service, 9%
  • Clerical Support, 7%
  • Computer System, 5%
  • Medical Claims, 4%
  • Process Claims, 4%
Common claims administrator skills
  • Data Entry, 12%
  • Customer Service, 9%
  • Process Claims, 8%
  • Phone Calls, 7%
  • HR, 5%
  • Insurance Claims, 5%

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Updated January 8, 2025

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