Claims service representative vs phone representative

The differences between claims service representatives and phone representatives 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 service representative and a phone representative. Additionally, a phone representative has an average salary of $42,827, which is higher than the $36,043 average annual salary of a claims service representative.

The top three skills for a claims service representative include insurance claims, customer service and policy coverage. The most important skills for a phone representative are customer service, outbound calls, and telephone calls.

Claims service representative vs phone representative overview

	Claims Service Representative	Phone Representative
Yearly salary	$36,043	$42,827
Hourly rate	$17.33	$20.59
Growth rate	-4%	-4%
Number of jobs	127,339	222,650
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 52%	High School Diploma, 37%
Average age	40	40
Years of experience	12	12

What does a claims service representative do?

Claims service representatives evaluate customer insurance claims. Their tasks in this career include interviewing witnesses or customers and visiting accident sites to assess the scope of the claim. Also, they determine whether it is worth arranging a settlement and make sure all settlement claims are managed quickly. In addition to evaluating accidents and claims, they renew customer policies based on their history. Qualifications for the job include a firm knowledge of overall company policy, computer literacy, and excellent customer service.

What does a phone representative do?

A Phone Representative answers customer calls, complaints, and inquiries professionally. They handle and resolve customer complaints related to its services/products and product/service sales. Besides processing applications, orders, and forms requested by customers, Phone Representatives also update customers about the products/services information. These professionals record customer complaints, inquiries, feedback, and actions taken. They develop and maintain mutually beneficial and professional relationships with each customer. Moreover, they create and maintain cordial relationships with all new customers.

Claims service representative vs phone representative salary

Claims service representatives and phone representatives have different pay scales, as shown below.

	Claims Service Representative	Phone Representative
Average salary	$36,043	$42,827
Salary range	Between $30,000 And $42,000	Between $26,000 And $68,000
Highest paying City	Urban Honolulu, HI	Norco, CA
Highest paying state	Alaska	California
Best paying company	Homeowners Choice	Press Ganey
Best paying industry	Government	Health Care

Differences between claims service representative and phone representative education

There are a few differences between a claims service representative and a phone representative in terms of educational background:

	Claims Service Representative	Phone Representative
Most common degree	Bachelor's Degree, 52%	High School Diploma, 37%
Most common major	Business	Business
Most common college	-	-

Claims service representative vs phone representative demographics

Here are the differences between claims service representatives' and phone representatives' demographics:

	Claims Service Representative	Phone Representative
Average age	40	40
Gender ratio	Male, 29.2% Female, 70.8%	Male, 34.6% Female, 65.4%
Race ratio	Black or African American, 12.8% Unknown, 5.2% Hispanic or Latino, 19.9% Asian, 6.1% White, 55.3% American Indian and Alaska Native, 0.7%	Black or African American, 10.0% Unknown, 5.2% Hispanic or Latino, 20.1% Asian, 5.5% White, 58.5% American Indian and Alaska Native, 0.7%
LGBT Percentage	7%	7%

Differences between claims service representative and phone representative duties and responsibilities

Claims service representative example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Experience in medical terminology, ICD9, CPT and DRG coding.
Review types of service on claims base on the CPT codes and diagnosis code.
Examine injure persons and administer first aid or cardiopulmonary resuscitation, if necessary, using training and medical supplies and equipment.
Coordinate EDI traffic with external clearinghouses and business partner Multiplan.
Process EDI reports, purge reports, and smart data reject list.

Phone representative example responsibilities.

Conduct telephone sales and interviews, compile and enter information into database, manage documents and insure customer satisfaction.
Provide status of medical claims and explain EOB's.
Research and resolve incorrect payments, EOB rejections and other issues with accounts.
Answer inbound provider calls to help with billing Medicaid claims and benefits and eligibility issues.
Update alumni on current happenings in university life and act as a liaison between past and current students.
Contact hundreds of alumni and their families by telephone and raise thousands of dollars to improve school facilities and maintain school grounds

Claims service representative vs phone representative skills

Common claims service representative skills

Insurance Claims, 12%
Customer Service, 11%
Policy Coverage, 8%
Phone Calls, 7%
Claims Process, 6%
Inbound Calls, 4%

Common phone representative skills

Customer Service, 27%
Outbound Calls, 13%
Telephone Calls, 7%
Inbound Phone Calls, 7%
Troubleshoot, 6%
Computer System, 3%

Claims Service Representative vs. similar jobs

Claims Service Representative related careers

Claims Service Representative related jobs

What similar roles do

Zippia Careers
Office and Administrative Industry
Claims Service Representative
Claims Service Representative vs Phone Representative

Updated January 8, 2025

Browse office and administrative jobs