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Claims service representative vs service center representative

The differences between claims service representatives and service center 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 service center representative. Additionally, a claims service representative has an average salary of $36,043, which is higher than the $33,420 average annual salary of a service center representative.

The top three skills for a claims service representative include insurance claims, customer service and policy coverage. The most important skills for a service center representative are patients, HR, and customer calls.

Claims service representative vs service center representative overview

Claims Service RepresentativeService Center Representative
Yearly salary$36,043$33,420
Hourly rate$17.33$16.07
Growth rate-4%-4%
Number of jobs127,339196,101
Job satisfaction--
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 56%
Average age4040
Years of experience1212

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 service center representative do?

A service center representative is responsible for providing the highest customer satisfaction by responding to the customers' inquiries and concerns and resolving complaints. Service center representatives may also sell products and services to the customers according to their needs and specifications. They also handle orders and payments, process replacements, and issue refunds as necessary. A service center representative must have excellent communication and organizational skills, especially in utilizing various computer applications to log customer information and create resolution reports for reference.

Claims service representative vs service center representative salary

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

Claims Service RepresentativeService Center Representative
Average salary$36,043$33,420
Salary rangeBetween $30,000 And $42,000Between $26,000 And $41,000
Highest paying CityUrban Honolulu, HIAlameda, CA
Highest paying stateAlaskaCalifornia
Best paying companyHomeowners ChoiceCisco
Best paying industryGovernmentInsurance

Differences between claims service representative and service center representative education

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

Claims Service RepresentativeService Center Representative
Most common degreeBachelor's Degree, 52%Bachelor's Degree, 56%
Most common majorBusinessBusiness
Most common college--

Claims service representative vs service center representative demographics

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

Claims Service RepresentativeService Center Representative
Average age4040
Gender ratioMale, 29.2% Female, 70.8%Male, 30.6% Female, 69.4%
Race ratioBlack 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, 10.8% Unknown, 5.2% Hispanic or Latino, 20.1% Asian, 6.5% White, 56.7% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between claims service representative and service center 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.
  • Show more

Service center representative example responsibilities.

  • Educate veterans and the college community on veteran's benefits and academic requirements need to accomplish academic goals.
  • Ensure that all telephone calls and pages are promptly handle in the best interest of Dartmouth-Hitchcock internal and external patients.
  • Maintain resident and guest confidentiality with strong understanding of HIPAA and privacy laws.
  • Assist participants with the benefit enrollment process by explaining types of insurance policies and IRS regulate spending accounts.
  • Instruct active and terminate participants with withdrawal options, process hardships and loans while also explaining IRS 1099R information.
  • Assist participants with inquiries relating to administration of healthcare reimbursement plans (FSA, HRA/HSA, and VEBA).
  • Show more

Claims service representative vs service center 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 service center representative skills
  • Patients, 14%
  • HR, 6%
  • Customer Calls, 5%
  • Phone Calls, 4%
  • Data Entry, 4%
  • Multitasking, 4%

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