Claims clerk vs claims coordinator

The differences between claims clerks and claims coordinators 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 clerk, becoming a claims coordinator takes usually requires 4-6 years. Additionally, a claims coordinator has an average salary of $38,620, 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 coordinator are customer service, patients, and data entry.

Claims clerk vs claims coordinator overview

	Claims Clerk	Claims Coordinator
Yearly salary	$32,815	$38,620
Hourly rate	$15.78	$18.57
Growth rate	-3%	-6%
Number of jobs	78,588	27,332
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 31%	Bachelor's Degree, 48%
Average age	44	44
Years of experience	4	6

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 coordinator do?

Claims coordinators are professionals who are responsible for coordinating activities that are related to handling and processing insurance claims for an organization. These coordinators must serve as liaison officer between the organization, insurance provider, and policyholders to communicate the status and eligibility for coverage for all relevant claims. They need to ensure that billing requirements are met by reviewing insurance claims. Claims coordinators must also answer all the inquiries of their clients while making recommendations to resolve any claim issues.

Claims clerk vs claims coordinator salary

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

	Claims Clerk	Claims Coordinator
Average salary	$32,815	$38,620
Salary range	Between $27,000 And $39,000	Between $31,000 And $47,000
Highest paying City	-	Federal Way, WA
Highest paying state	-	New Jersey
Best paying company	-	Xcel Energy
Best paying industry	-	Finance

Differences between claims clerk and claims coordinator education

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

	Claims Clerk	Claims Coordinator
Most common degree	Bachelor's Degree, 31%	Bachelor's Degree, 48%
Most common major	Business	Business
Most common college	-	-

Claims clerk vs claims coordinator demographics

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

	Claims Clerk	Claims Coordinator
Average age	44	44
Gender ratio	Male, 17.5% Female, 82.5%	Male, 24.6% Female, 75.4%
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, 11.2% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	10%

Differences between claims clerk and claims coordinator 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.

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Claims coordinator example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
Serve as point of contact for all legal issues relate to HIPAA.
Streamline audit procedures of TPA and maintain extremely high production rate which help in keeping staffing requirements lower.
Review and audit claims -Using correct CPT and DX codes -Denial reports -correct billing error, resubmitted claims for proper payment
Communicate with company management, injure workers/customers, medical providers and TPA, as necessary, regarding claim relate matters.

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Claims clerk vs claims coordinator 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 coordinator skills

Customer Service, 23%
Patients, 9%
Data Entry, 8%
Phone Calls, 6%
Insurance Claims, 5%
Quality Standards, 4%

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Updated January 8, 2025

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