Claims director vs senior claims representative

The differences between claims directors and senior 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 senior claims representative. Additionally, a claims director has an average salary of $118,250, which is higher than the $54,592 average annual salary of a senior claims representative.

The top three skills for a claims director include customer service, litigation and oversight. The most important skills for a senior claims representative are customer service, claims handling, and litigation.

Claims director vs senior claims representative overview

	Claims Director	Senior Claims Representative
Yearly salary	$118,250	$54,592
Hourly rate	$56.85	$26.25
Growth rate	-6%	-6%
Number of jobs	13,299	10,995
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 75%
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 senior claims representative do?

A senior claims representative serves as a client's primary point of contact when processing insurance claims. Their responsibilities include meeting with clients to identify their needs, gathering and verifying documentation, conducting investigations to determine the validity of insurance claims, liaising with external parties, and negotiating the amount of compensation. Furthermore, as a senior claims representative, it is essential to lead and serve as a mentor to junior claims representatives, all while implementing the company's policies and regulations, including its vision and mission.

Claims director vs senior claims representative salary

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

	Claims Director	Senior Claims Representative
Average salary	$118,250	$54,592
Salary range	Between $73,000 And $190,000	Between $31,000 And $94,000
Highest paying City	-	-
Highest paying state	-	-
Best paying company	-	-
Best paying industry	-	-

Differences between claims director and senior claims representative education

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

	Claims Director	Senior Claims Representative
Most common degree	Bachelor's Degree, 68%	Bachelor's Degree, 75%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Claims director vs senior claims representative demographics

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

	Claims Director	Senior Claims Representative
Average age	44	44
Gender ratio	Male, 58.2% Female, 41.8%	Male, 47.3% Female, 52.7%
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, 16.5% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between claims director and senior 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.

Senior claims representative example responsibilities.

Conduct detailed interviews with physicians, prepare comprehensive written reports, retain defense counsel, and effectively manage the litigation process.
Utilize Xactimate estimating system during field inspection to properly evaluate commercial property damages.
Update computer generate claim file (s) with medical diagnoses, current CPT and ICD codes.
Analyze claims using IDC and CPT coding and negotiate settlements with attorneys, claimants, medical providers, and insureds.
Set up independent medical examinations, issue denials, attend arbitration hearings.
Coordinate and attend various mediation and arbitration hearings as well as numerous settlement hearings and conferences.

Claims director vs senior claims representative skills

Common claims director skills

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

Common senior claims representative skills

Customer Service, 26%
Claims Handling, 14%
Litigation, 9%
Insurance Claims, 3%
Bodily Injury Claims, 3%
Automobile Claims, 3%

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Claims Director
Claims Director vs Senior Claims Representative

Updated January 8, 2025

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