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Claims resolution specialist vs center specialist

The differences between claims resolution specialists and center specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a claims resolution specialist and a center specialist. Additionally, a claims resolution specialist has an average salary of $38,432, which is higher than the $33,648 average annual salary of a center specialist.

The top three skills for a claims resolution specialist include patients, medical terminology and insurance claims. The most important skills for a center specialist are patients, customer service, and necessary paperwork.

Claims resolution specialist vs center specialist overview

Claims Resolution SpecialistCenter Specialist
Yearly salary$38,432$33,648
Hourly rate$18.48$16.18
Growth rate-4%-4%
Number of jobs55,413226,751
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 47%
Average age4040
Years of experience1212

What does a claims resolution specialist do?

Claims resolution specialists are in charge of outstanding claims follow-ups, submitting appeals, and corresponding to work claims. To be good at this job, they find different techniques to resolve outstanding patient claims. When performing their duties, these specialists make sure that they work with professionalism and high detail quality. They should be comfortable with navigating computerized claims and various platforms while assisting their clients over the phone. These types of specialists also always maintain the confidentiality of their members' data.

What does a center specialist do?

A call center specialist is an individual who interacts with customers over the phone to ensure smooth transactions and answer customer queries. Call center specialists provide customer service through the phone and handle complaints under the company's guidance and with professionalism and courtesy. They must verify the information for incoming orders and enter them into the database with accuracy. Call center specialists should maintain the call center database and must regularly update the contact log. They must also report malfunctioning equipment and software to their supervisors.

Claims resolution specialist vs center specialist salary

Claims resolution specialists and center specialists have different pay scales, as shown below.

Claims Resolution SpecialistCenter Specialist
Average salary$38,432$33,648
Salary rangeBetween $30,000 And $47,000Between $24,000 And $46,000
Highest paying City-Boston, MA
Highest paying state-New Hampshire
Best paying company-BP America Inc
Best paying industry-Finance

Differences between claims resolution specialist and center specialist education

There are a few differences between a claims resolution specialist and a center specialist in terms of educational background:

Claims Resolution SpecialistCenter Specialist
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 47%
Most common majorBusinessBusiness
Most common college--

Claims resolution specialist vs center specialist demographics

Here are the differences between claims resolution specialists' and center specialists' demographics:

Claims Resolution SpecialistCenter Specialist
Average age4040
Gender ratioMale, 26.0% Female, 74.0%Male, 46.4% Female, 53.6%
Race ratioBlack or African American, 11.4% Unknown, 5.1% Hispanic or Latino, 20.6% Asian, 6.2% White, 56.0% American Indian and Alaska Native, 0.6%Black or African American, 11.4% Unknown, 5.2% Hispanic or Latino, 20.0% Asian, 7.1% White, 55.5% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between claims resolution specialist and center specialist duties and responsibilities

Claims resolution specialist example responsibilities.

  • Manage expedition of appeals via problem solving and collaboration with other departments.
  • Assist provider with ICD-9, CPT and revenue codes, DME, coordination of benefits, efficiently train on HIPPA.
  • Process medical claims submit to Kansas Medicaid using establish guidelines and policies.
  • Ensure compliance with HIPAA regulations and requirements.
  • Determine the types of claims using submit diagnoses, CPT, and HCPS codes.
  • Communicate with claimants and insure individuals alike while ensuring privacy and HIPPA laws are maintain.
  • Show more

Center specialist example responsibilities.

  • Manage and troubleshoot applications and printers across exchange servers.
  • Retain knowledge for xerox printers as well as microsoft office.
  • Maintain supplies in the CPC and canvass weekly to keep sales high.
  • Sort checks in order of bank of first deposit and encode ACH debits.
  • Provide new POS (point of sale) system training for stores within the district.
  • Adhere to the Weill Cornell procedures, NYPH policies and procedures, OSHA regulations and HIPAA guidelines
  • Show more

Claims resolution specialist vs center specialist skills

Common claims resolution specialist skills
  • Patients, 13%
  • Medical Terminology, 7%
  • Insurance Claims, 6%
  • Patient Accounts, 5%
  • Medicaid, 5%
  • CPT, 5%
Common center specialist skills
  • Patients, 16%
  • Customer Service, 7%
  • Necessary Paperwork, 6%
  • Ladders, 5%
  • Safety Procedures, 5%
  • Excellent Interpersonal, 4%

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