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Claims support specialist vs claim specialist

The differences between claims support specialists and claim specialists 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 support specialist, becoming a claim specialist takes usually requires 4-6 years. Additionally, a claim specialist has an average salary of $43,164, which is higher than the $37,033 average annual salary of a claims support specialist.

The top three skills for a claims support specialist include data entry, dictation and claims support. The most important skills for a claim specialist are customer service, litigation, and patients.

Claims support specialist vs claim specialist overview

Claims Support SpecialistClaim Specialist
Yearly salary$37,033$43,164
Hourly rate$17.80$20.75
Growth rate-4%-6%
Number of jobs120,65029,505
Job satisfaction--
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 54%
Average age4044
Years of experience126

What does a claims support specialist do?

Claims support specialists are the ones who make sure that the right amount of reimbursement rates is paid based on their client's contracts. Their job includes processing medical record requests and reviewing the secondary and tertiary claims for legitimacy. Working with physician and billing office employees to find resolutions for outstanding claim issues is a part of their responsibilities as claim support specialists. They also make follow up calls about unprocessed or denied insurance claims. And having good communication skills and knowledge in healthcare receivables and collections will help them succeed.

What does a claim specialist do?

A claims specialist is responsible for processing insurance claims, reviewing insurance coverage, and analyzing claims cases. Claims specialists' duties include negotiating claims settlements, validating claims to prevent fraud, creating court testimonies as needed, developing claim review plans, and checking necessary documents and related resolve claims. A claims specialist must have strong analytical and critical-thinking skills to authorize claim payment and investigate complex and unusual claims. Claims specialists should also have extensive knowledge of the insurance processes to handle various cases, following legal policies and regulatory procedures.

Claims support specialist vs claim specialist salary

Claims support specialists and claim specialists have different pay scales, as shown below.

Claims Support SpecialistClaim Specialist
Average salary$37,033$43,164
Salary rangeBetween $28,000 And $47,000Between $27,000 And $67,000
Highest paying CityRancho Cordova, CANewark, NJ
Highest paying stateMassachusettsNew Jersey
Best paying companyW. R. BerkleyW. R. Berkley
Best paying industryInsuranceInsurance

Differences between claims support specialist and claim specialist education

There are a few differences between a claims support specialist and a claim specialist in terms of educational background:

Claims Support SpecialistClaim Specialist
Most common degreeBachelor's Degree, 45%Bachelor's Degree, 54%
Most common majorBusinessBusiness
Most common college-Stanford University

Claims support specialist vs claim specialist demographics

Here are the differences between claims support specialists' and claim specialists' demographics:

Claims Support SpecialistClaim Specialist
Average age4044
Gender ratioMale, 22.3% Female, 77.7%Male, 31.0% Female, 69.0%
Race ratioBlack or African American, 11.3% Unknown, 4.9% Hispanic or Latino, 18.3% Asian, 6.8% White, 58.1% American Indian and Alaska Native, 0.6%Black or African American, 11.4% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.1% American Indian and Alaska Native, 0.5%
LGBT Percentage7%10%

Differences between claims support specialist and claim specialist duties and responsibilities

Claims support specialist example responsibilities.

  • Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
  • Key in DC Medicaid claims for processing.
  • Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.
  • Review and process HMO facility and professional claims determining benefits due in accordance to plan/policy provisions.

Claim specialist example responsibilities.

  • Assist in the streamlining of EDI process to manage workflow of EDI claims.
  • Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
  • Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
  • Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
  • Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
  • Manage expedition of appeals via problem solving and collaboration with other departments.
  • Show more

Claims support specialist vs claim specialist skills

Common claims support specialist skills
  • Data Entry, 21%
  • Dictation, 10%
  • Claims Support, 9%
  • Loss Reports, 6%
  • Customer Service, 6%
  • Office Equipment, 5%
Common claim specialist skills
  • Customer Service, 19%
  • Litigation, 7%
  • Patients, 5%
  • Claims Handling, 4%
  • Quality Standards, 4%
  • Excellent Organizational, 4%

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