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Claims resolution specialist vs retention specialist

The differences between claims resolution specialists and retention 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 retention specialist. Additionally, a claims resolution specialist has an average salary of $38,432, which is higher than the $37,175 average annual salary of a retention specialist.

The top three skills for a claims resolution specialist include patients, medical terminology and insurance claims. The most important skills for a retention specialist are customer service, outbound calls, and powerpoint.

Claims resolution specialist vs retention specialist overview

Claims Resolution SpecialistRetention Specialist
Yearly salary$38,432$37,175
Hourly rate$18.48$17.87
Growth rate-4%-4%
Number of jobs55,413199,631
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 40%
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 retention specialist do?

A retention specialist is responsible for devising strategies to maintain a healthy relationship with clients. They are primarily in charge of negotiating and securing contract renewals, handling issues and corrective measures for customer satisfaction, utilizing feedback to improve services, and maintaining a healthy rapport to strengthen the client base. Furthermore, as a retention specialist, it is essential to perform calls and correspondence, keep records of all transactions, and coordinate with work-staff.

Claims resolution specialist vs retention specialist salary

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

Claims Resolution SpecialistRetention Specialist
Average salary$38,432$37,175
Salary rangeBetween $30,000 And $47,000Between $28,000 And $48,000
Highest paying City-Los Angeles, CA
Highest paying state-California
Best paying company-Adobe
Best paying industry-Finance

Differences between claims resolution specialist and retention specialist education

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

Claims Resolution SpecialistRetention Specialist
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 40%
Most common majorBusinessBusiness
Most common college--

Claims resolution specialist vs retention specialist demographics

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

Claims Resolution SpecialistRetention Specialist
Average age4040
Gender ratioMale, 26.0% Female, 74.0%Male, 37.0% Female, 63.0%
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, 5.3% Hispanic or Latino, 20.6% Asian, 6.0% White, 55.9% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between claims resolution specialist and retention 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

Retention specialist example responsibilities.

  • Save customer relationship by managing and exceeding TWC goals.
  • Prepare proposals and analysis for county Medicaid facilitators to educate regarding available manage care programs.
  • Increase revenue through up-selling and cross-selling video, HSI, wireless, and telephony services to existing customers.
  • Provide advance troubleshooting of wireless broadband, IP services, PC's, wireless routers.
  • Process payments via CSG and ICOMS.
  • Provide rep support, assist with account flow, escalation, reschedule, expedites, construction/survey.
  • Show more

Claims resolution specialist vs retention specialist skills

Common claims resolution specialist skills
  • Patients, 13%
  • Medical Terminology, 7%
  • Insurance Claims, 6%
  • Patient Accounts, 5%
  • Medicaid, 5%
  • CPT, 5%
Common retention specialist skills
  • Customer Service, 26%
  • Outbound Calls, 11%
  • PowerPoint, 5%
  • Customer Satisfaction, 5%
  • Customer Accounts, 4%
  • Billing Issues, 3%

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