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The differences between claims resolution specialists and reimbursement 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 reimbursement specialist. Additionally, a claims resolution specialist has an average salary of $38,432, which is higher than the $38,273 average annual salary of a reimbursement specialist.
The top three skills for a claims resolution specialist include patients, medical terminology and insurance claims. The most important skills for a reimbursement specialist are patients, customer service, and appeals.
| Claims Resolution Specialist | Reimbursement Specialist | |
| Yearly salary | $38,432 | $38,273 |
| Hourly rate | $18.48 | $18.40 |
| Growth rate | -4% | 11% |
| Number of jobs | 55,413 | 32,292 |
| Job satisfaction | - | - |
| Most common degree | Bachelor's Degree, 52% | Bachelor's Degree, 40% |
| Average age | 40 | 45 |
| Years of experience | 12 | 12 |
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.
A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.
Claims resolution specialists and reimbursement specialists have different pay scales, as shown below.
| Claims Resolution Specialist | Reimbursement Specialist | |
| Average salary | $38,432 | $38,273 |
| Salary range | Between $30,000 And $47,000 | Between $29,000 And $49,000 |
| Highest paying City | - | Lynchburg, VA |
| Highest paying state | - | Virginia |
| Best paying company | - | Novartis |
| Best paying industry | - | Pharmaceutical |
There are a few differences between a claims resolution specialist and a reimbursement specialist in terms of educational background:
| Claims Resolution Specialist | Reimbursement Specialist | |
| Most common degree | Bachelor's Degree, 52% | Bachelor's Degree, 40% |
| Most common major | Business | Business |
| Most common college | - | University of Pennsylvania |
Here are the differences between claims resolution specialists' and reimbursement specialists' demographics:
| Claims Resolution Specialist | Reimbursement Specialist | |
| Average age | 40 | 45 |
| Gender ratio | Male, 26.0% Female, 74.0% | Male, 15.2% Female, 84.8% |
| Race ratio | Black 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, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3% |
| LGBT Percentage | 7% | 9% |