Claims reviewer vs claims clerk

The differences between claims reviewers and claims clerks can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 6-12 months to become a claims reviewer, becoming a claims clerk takes usually requires 2-4 years. Additionally, a claims reviewer has an average salary of $41,011, which is higher than the $32,815 average annual salary of a claims clerk.

The top three skills for a claims reviewer include home health, insurance claims and data entry. The most important skills for a claims clerk are data entry, customer service, and clerical support.

Claims reviewer vs claims clerk overview

	Claims Reviewer	Claims Clerk
Yearly salary	$41,011	$32,815
Hourly rate	$19.72	$15.78
Growth rate	-4%	-3%
Number of jobs	9,789	78,588
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 55%	Bachelor's Degree, 31%
Average age	40	44
Years of experience	12	4

Claims reviewer vs claims clerk salary

Claims reviewers and claims clerks have different pay scales, as shown below.

	Claims Reviewer	Claims Clerk
Average salary	$41,011	$32,815
Salary range	Between $30,000 And $54,000	Between $27,000 And $39,000
Highest paying City	-	-
Highest paying state	-	-
Best paying company	-	-
Best paying industry	-	-

Differences between claims reviewer and claims clerk education

There are a few differences between a claims reviewer and a claims clerk in terms of educational background:

	Claims Reviewer	Claims Clerk
Most common degree	Bachelor's Degree, 55%	Bachelor's Degree, 31%
Most common major	Business	Business
Most common college	-	-

Claims reviewer vs claims clerk demographics

Here are the differences between claims reviewers' and claims clerks' demographics:

	Claims Reviewer	Claims Clerk
Average age	40	44
Gender ratio	Male, 30.2% Female, 69.8%	Male, 17.5% Female, 82.5%
Race ratio	Black or African American, 15.5% Unknown, 5.0% Hispanic or Latino, 16.3% Asian, 7.2% White, 55.4% American Indian and Alaska Native, 0.6%	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	7%	11%

Differences between claims reviewer and claims clerk duties and responsibilities

Claims reviewer example responsibilities.

Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
Review worker comp claims base on state fee schedule and ICD-9 guidelines.
Research ICD-9 codes and verify they are equivalent with customer s diagnoses.
Review accounts per OCC guidelines that all efforts are met and due diligence complete.
Research claims, review document findings and execute OCC approve harm test for each file.
Help maintain company compliance with FDA and ICH Regulations/Guidelines governing the reporting of adverse event reports.

Claims clerk example responsibilities.

Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
File commercial, worker's comp, Medicare, and Medicaid claims to insurance carriers and employers.
Open and sort mail by claim types (HCPA UB 92 and T18).
Process medical HMO claims, POS claims, PPO claims and fee for service claims.
Review, scan, and file HCFA forms
Audit paper claims for accuracy in CPT and ICD9 codes.

Claims reviewer vs claims clerk skills

Common claims reviewer skills

Home Health, 50%
Insurance Claims, 5%
Data Entry, 5%
Medical Terminology, 3%
CPT, 3%
Claims Submission, 3%

Common claims clerk skills

Data Entry, 26%
Customer Service, 9%
Clerical Support, 7%
Computer System, 5%
Medical Claims, 4%
Process Claims, 4%