Claims director vs medical claims analyst

The differences between claims directors and medical claims analysts 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 medical claims analyst. Additionally, a claims director has an average salary of $118,250, which is higher than the $46,708 average annual salary of a medical claims analyst.

The top three skills for a claims director include customer service, litigation and oversight. The most important skills for a medical claims analyst are medical terminology, medicaid, and medical insurance claims.

Claims director vs medical claims analyst overview

	Claims Director	Medical Claims Analyst
Yearly salary	$118,250	$46,708
Hourly rate	$56.85	$22.46
Growth rate	-6%	-6%
Number of jobs	13,299	65,897
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 36%
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 medical claims analyst do?

A medical claims analyst audits or verifies medical claims in insurance companies. Medical claims analysts make sure that corporate reimbursement payments are accurate. Usually, they work at an office on a computer workstation. They receive Medicaid claims from specialty and medical providers for reimbursement. Their job includes the development of an enhanced procedure in handling difficult Medicare/Medicaid letters while complying with the set policies.

Claims director vs medical claims analyst salary

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

	Claims Director	Medical Claims Analyst
Average salary	$118,250	$46,708
Salary range	Between $73,000 And $190,000	Between $32,000 And $68,000
Highest paying City	-	Bridgewater, NJ
Highest paying state	-	New Jersey
Best paying company	-	Montefiore Mount Vernon Hospital
Best paying industry	-	Insurance

Differences between claims director and medical claims analyst education

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

	Claims Director	Medical Claims Analyst
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 36%
Most common major	Business	Business
Most common college	Stanford University	University of Pennsylvania

Claims director vs medical claims analyst demographics

Here are the differences between claims directors' and medical claims analysts' demographics:

	Claims Director	Medical Claims Analyst
Average age	44	44
Gender ratio	Male, 58.2% Female, 41.8%	Male, 14.2% Female, 85.8%
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, 11.2% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.4% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims director and medical claims analyst 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.

Medical claims analyst example responsibilities.

Manage cases by aggressively directing the litigation process.
Analyze incoming medical claims using ICD-9, CPT, HCPCS coding, and Medicare fee schedules.
Determine if claims are in compliance under patient benefit plans for payments using DRG regulations :
Review medical records to determine if the ICD-9, CPT codes and modifiers are processed correctly.
Adhere to the HIPAA privacy, security regulations, and maintain confidentiality of patient a business records.
Research medical claims issues in response to informational inquiries by accessing and interpreting EOB's and claims history.

Claims director vs medical claims analyst skills

Common claims director skills

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

Common medical claims analyst skills

Medical Terminology, 9%
Medicaid, 6%
Medical Insurance Claims, 6%
Customer Service, 6%
Data Entry, 6%
Patients, 5%

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Claims Director
Claims Director vs Medical Claims Analyst

Updated January 8, 2025

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