Insurance claims processor vs claims coordinator

The differences between insurance claims processors and claims coordinators can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become an insurance claims processor, becoming a claims coordinator takes usually requires 4-6 years. Additionally, a claims coordinator has an average salary of $38,620, which is higher than the $37,151 average annual salary of an insurance claims processor.

The top three skills for an insurance claims processor include data entry, customer service and medicaid. The most important skills for a claims coordinator are customer service, patients, and data entry.

Insurance claims processor vs claims coordinator overview

	Insurance Claims Processor	Claims Coordinator
Yearly salary	$37,151	$38,620
Hourly rate	$17.86	$18.57
Growth rate	-3%	-6%
Number of jobs	48,777	27,332
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 30%	Bachelor's Degree, 48%
Average age	44	44
Years of experience	4	6

What does an insurance claims processor do?

A claims processor usually works in health or property insurance claims. They are responsible for processing and evaluating the claim forms, monitoring and verifying information, and closely communicating with the company's clients, beneficiaries, and agents. Also, they handle queries and comments, calculate possible claims, and process of various payments. They also need to ensure all insurance company guidelines and policies are adhered to in order to avoid discrepancies, issues, and other problems regarding a client's claims.

What does a claims coordinator do?

Claims coordinators are professionals who are responsible for coordinating activities that are related to handling and processing insurance claims for an organization. These coordinators must serve as liaison officer between the organization, insurance provider, and policyholders to communicate the status and eligibility for coverage for all relevant claims. They need to ensure that billing requirements are met by reviewing insurance claims. Claims coordinators must also answer all the inquiries of their clients while making recommendations to resolve any claim issues.

Insurance claims processor vs claims coordinator salary

Insurance claims processors and claims coordinators have different pay scales, as shown below.

	Insurance Claims Processor	Claims Coordinator
Average salary	$37,151	$38,620
Salary range	Between $30,000 And $45,000	Between $31,000 And $47,000
Highest paying City	Eden Prairie, MN	Federal Way, WA
Highest paying state	Connecticut	New Jersey
Best paying company	Accenture	Xcel Energy
Best paying industry	Insurance	Finance

Differences between insurance claims processor and claims coordinator education

There are a few differences between an insurance claims processor and a claims coordinator in terms of educational background:

	Insurance Claims Processor	Claims Coordinator
Most common degree	Bachelor's Degree, 30%	Bachelor's Degree, 48%
Most common major	Business	Business
Most common college	-	-

Insurance claims processor vs claims coordinator demographics

Here are the differences between insurance claims processors' and claims coordinators' demographics:

	Insurance Claims Processor	Claims Coordinator
Average age	44	44
Gender ratio	Male, 20.3% Female, 79.7%	Male, 24.6% Female, 75.4%
Race ratio	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%	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	10%

Differences between insurance claims processor and claims coordinator duties and responsibilities

Insurance claims processor example responsibilities.

Manage cases by aggressively directing the litigation process.
Maintain confidentiality in accordance with HIPAA laws.
Process ICD-9 codes, diagnostic and procedure codes.
Handle confidential information according to HIPPA and JAACHO standards.
Follow and comply with HIPPA rules and regulations to ensure patient privacy.
Process medical and dental claims using appropriate CPT, ICD-9, and ADA coding.

Claims coordinator example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
Serve as point of contact for all legal issues relate to HIPAA.
Streamline audit procedures of TPA and maintain extremely high production rate which help in keeping staffing requirements lower.
Review and audit claims -Using correct CPT and DX codes -Denial reports -correct billing error, resubmitted claims for proper payment
Communicate with company management, injure workers/customers, medical providers and TPA, as necessary, regarding claim relate matters.

Insurance claims processor vs claims coordinator skills

Common insurance claims processor skills

Data Entry, 18%
Customer Service, 11%
Medicaid, 8%
Medical Terminology, 6%
Insurance Coverage, 5%
ICD-9, 4%

Common claims coordinator skills

Customer Service, 23%
Patients, 9%
Data Entry, 8%
Phone Calls, 6%
Insurance Claims, 5%
Quality Standards, 4%

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Insurance Claims Processor
Insurance Claims Processor vs Claims Coordinator

Updated January 8, 2025

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