Claims director vs claims representative

The differences between claims directors and claims representatives can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a claims director and a claims representative. Additionally, a claims director has an average salary of $118,250, which is higher than the $38,796 average annual salary of a claims representative.

The top three skills for a claims director include customer service, litigation and oversight. The most important skills for a claims representative are customer service, quality standards, and policy coverage.

Claims director vs claims representative overview

	Claims Director	Claims Representative
Yearly salary	$118,250	$38,796
Hourly rate	$56.85	$18.65
Growth rate	-6%	-6%
Number of jobs	13,299	18,565
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 62%
Average age	44	44
Years of experience	6	6

What does a claims director do?

A claims director spearheads and oversees the daily operations of an insurance company's claims department. They have the authority to make decisions and changes, set goals and timelines, establish guidelines and budgets, liaise with key external partners, coordinate managers and teams, delegate responsibilities, and conduct research and analysis to find opportunities that will optimize the department's operations. Moreover, a claims director leads and encourages staff to reach goals, all while implementing the company's claims policies and regulations, developing new ones as needed.

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 director vs claims representative salary

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

	Claims Director	Claims Representative
Average salary	$118,250	$38,796
Salary range	Between $73,000 And $190,000	Between $28,000 And $53,000
Highest paying City	-	Dearborn, MI
Highest paying state	-	New Jersey
Best paying company	-	W. R. Berkley
Best paying industry	-	Government

Differences between claims director and claims representative education

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

	Claims Director	Claims Representative
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 62%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims director vs claims representative demographics

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

	Claims Director	Claims Representative
Average age	44	44
Gender ratio	Male, 58.2% Female, 41.8%	Male, 37.5% Female, 62.5%
Race ratio	Black or African American, 10.7% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 62.2% 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	10%	10%

Differences between claims director and claims representative duties and responsibilities

Claims director example responsibilities.

Create project team that comply with new Medicare reporting requirements achieving successful reporting to CMS.
Maintain relationships with attorneys and manage litigation strategy; ensure strong relationships with insureds, brokers and third party administrators.
Redesign processes and procedures for managing litigation through the implementation of an aggressive process for managing discovery and case typing.
General knowledge of CPT, ICD-9, HCPCS, DRG and Medicode (UCR), bundling and unbundling.
File and respond to online arbitration matters.
Facilitate annual updates to all new and revise CPT codes assuring accurate claims payment.

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 director vs claims representative skills

Common claims director skills

Customer Service, 17%
Litigation, 11%
Oversight, 9%
Coverage Issues, 6%
Claims Handling, 5%
Claims Operations, 5%

Common claims representative skills

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

Claims Director vs. similar jobs

Claims Director related careers

Claims Director related jobs

What similar roles do

Zippia Careers
Business and Financial Industry
Claims Director
Claims Director vs Claims Representative

Updated January 8, 2025

Browse business and financial jobs