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Claims resolution specialist vs customer relations specialist

The differences between claims resolution specialists and customer relations 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 customer relations specialist. Additionally, a claims resolution specialist has an average salary of $38,432, which is higher than the $37,827 average annual salary of a customer relations specialist.

The top three skills for a claims resolution specialist include patients, medical terminology and insurance claims. The most important skills for a customer relations specialist are customer relations, data entry, and work ethic.

Claims resolution specialist vs customer relations specialist overview

Claims Resolution SpecialistCustomer Relations Specialist
Yearly salary$38,432$37,827
Hourly rate$18.48$18.19
Growth rate-4%-4%
Number of jobs55,413215,862
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 52%
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 customer relations specialist do?

A customer relations specialist is responsible for providing high-quality services for customers by responding to their inquiries and concerns and resolving complaints about the company's goods and services. Customer relations specialists update customer accounts on the database, recording their transactions accurately, and posting their payments timely. They may also sell new products and services to the clients, demonstrating features and usability, processing orders, and confirming delivery details. A customer relations specialist must have excellent communication and organizational skills to ensure customer satisfaction and maintain healthy business relationships with the customers.

Claims resolution specialist vs customer relations specialist salary

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

Claims Resolution SpecialistCustomer Relations Specialist
Average salary$38,432$37,827
Salary rangeBetween $30,000 And $47,000Between $27,000 And $52,000
Highest paying City-Columbia, MD
Highest paying state-Massachusetts
Best paying company-Deloitte
Best paying industry-Automotive

Differences between claims resolution specialist and customer relations specialist education

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

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

Claims resolution specialist vs customer relations specialist demographics

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

Claims Resolution SpecialistCustomer Relations Specialist
Average age4040
Gender ratioMale, 26.0% Female, 74.0%Male, 31.8% Female, 68.2%
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, 11.7% Unknown, 5.3% Hispanic or Latino, 19.5% Asian, 7.5% White, 55.5% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between claims resolution specialist and customer relations 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

Customer relations specialist example responsibilities.

  • Manage software maintenance renewal partner and assist with upselling additional and higher functionality licenses to increase revenue.
  • Verify insurance eligibility and benefits of patients that are being provide oxygen home and travel units and durable medical equipment.
  • Create Powerpoint company informational videos.
  • Communicate with customers and FedEx to facilitate resolutions of any shipping or delivery issues.

Claims resolution specialist vs customer relations specialist skills

Common claims resolution specialist skills
  • Patients, 13%
  • Medical Terminology, 7%
  • Insurance Claims, 6%
  • Patient Accounts, 5%
  • Medicaid, 5%
  • CPT, 5%
Common customer relations specialist skills
  • Customer Relations, 37%
  • Data Entry, 10%
  • Work Ethic, 9%
  • Customer Retention, 5%
  • Outbound Calls, 5%
  • Schedule Appointments, 4%

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