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Claims resolution specialist vs client care specialist

The differences between claims resolution specialists and client care 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 client care specialist. Additionally, a claims resolution specialist has an average salary of $38,432, which is higher than the $29,660 average annual salary of a client care specialist.

The top three skills for a claims resolution specialist include patients, medical terminology and insurance claims. The most important skills for a client care specialist are client care, PET, and patients.

Claims resolution specialist vs client care specialist overview

Claims Resolution SpecialistClient Care Specialist
Yearly salary$38,432$29,660
Hourly rate$18.48$14.26
Growth rate-4%-4%
Number of jobs55,413132,935
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 50%
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 client care specialist do?

Client care specialists are employees who manage a company's 24/7 hotline number. Most customer care specialists have call center experience before achieving their positions. This way, they know how to personalize the way they handle different types of clients. They can also impart firsthand knowledge to new call center employees about the job. Their usual responsibilities revolve around presenting the weekly and monthly reports on the teams' performances to the management, documenting customer interactions, reviewing customer complaints and taking appropriate actions, and being updated on their product.

Claims resolution specialist vs client care specialist salary

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

Claims Resolution SpecialistClient Care Specialist
Average salary$38,432$29,660
Salary rangeBetween $30,000 And $47,000Between $18,000 And $46,000
Highest paying City-Irvine, CA
Highest paying state-Alaska
Best paying company-Bank of America
Best paying industry-Finance

Differences between claims resolution specialist and client care specialist education

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

Claims Resolution SpecialistClient Care Specialist
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 50%
Most common majorBusinessBusiness
Most common college--

Claims resolution specialist vs client care specialist demographics

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

Claims Resolution SpecialistClient Care Specialist
Average age4040
Gender ratioMale, 26.0% Female, 74.0%Male, 20.3% Female, 79.7%
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, 10.7% Unknown, 5.4% Hispanic or Latino, 19.6% Asian, 7.0% White, 56.6% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between claims resolution specialist and client care 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

Client care specialist example responsibilities.

  • Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
  • Credential new physicians, clinics and triage centers with Medicare/Medicaid and major insurance plans for territory.
  • Assign to cable company supporting cable products, schedule installation appointments and troubleshoot issues with customers in a call center environment
  • Conduct teleconferences, schedule customer reservations and maintain teleconferencing database.

Claims resolution specialist vs client care specialist skills

Common claims resolution specialist skills
  • Patients, 13%
  • Medical Terminology, 7%
  • Insurance Claims, 6%
  • Patient Accounts, 5%
  • Medicaid, 5%
  • CPT, 5%
Common client care specialist skills
  • Client Care, 14%
  • PET, 11%
  • Patients, 8%
  • Scheduling Appointments, 8%
  • Customer Service, 7%
  • Excellent Interpersonal, 5%

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