Insurance claims processor vs insurance clerk

The differences between insurance claims processors and insurance clerks can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both an insurance claims processor and an insurance clerk. Additionally, an insurance claims processor has an average salary of $37,151, which is higher than the $33,089 average annual salary of an insurance clerk.

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

Insurance claims processor vs insurance clerk overview

	Insurance Claims Processor	Insurance Clerk
Yearly salary	$37,151	$33,089
Hourly rate	$17.86	$15.91
Growth rate	-3%	-3%
Number of jobs	48,777	147,755
Job satisfaction	-	2
Most common degree	Bachelor's Degree, 30%	High School Diploma, 29%
Average age	44	44
Years of experience	4	4

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 an insurance clerk do?

An insurance clerk usually works to process insurance, reinstatement, changes, or cancellations for a company or an individual account. They are responsible for monitoring, processing, and organizing different insurance claims for a client. They usually work closely with the company's insurance agent to provide necessary information to process the clients' application. This career requires a broad knowledge of local and state insurance policies, good attention to detail, excellent communication skills, customer service skills, and administrative skills.

Insurance claims processor vs insurance clerk salary

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

	Insurance Claims Processor	Insurance Clerk
Average salary	$37,151	$33,089
Salary range	Between $30,000 And $45,000	Between $27,000 And $39,000
Highest paying City	Eden Prairie, MN	Henderson, NV
Highest paying state	Connecticut	New Hampshire
Best paying company	Accenture	Lenoir Memorial Hospital
Best paying industry	Insurance	Finance

Differences between insurance claims processor and insurance clerk education

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

	Insurance Claims Processor	Insurance Clerk
Most common degree	Bachelor's Degree, 30%	High School Diploma, 29%
Most common major	Business	Business
Most common college	-	-

Insurance claims processor vs insurance clerk demographics

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

	Insurance Claims Processor	Insurance Clerk
Average age	44	44
Gender ratio	Male, 20.3% Female, 79.7%	Male, 8.3% Female, 91.7%
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, 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	11%	11%

Differences between insurance claims processor and insurance clerk 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.

Insurance clerk example responsibilities.

Manage front office check-in, insurance verification and certifications from doctors.
Establish and implement procedures for completion of patient super bills with proper diagnostic coding utilizing ICD-9 and CPT code manuals.
Maintain patient medical records insuring diagnosis codes (ICD-9) are itemized correctly and name and address of insurance carriers record.
Schedule and obtain authorization for outpatient procedures for patients via private insurance, worker's compensation, and Medicare/ Medicaid.
Complete several ICD-10 training courses.
Perform medical coding with most accurate and descriptive HCPCS code.

Insurance claims processor vs insurance clerk skills

Common insurance claims processor skills

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

Common insurance clerk skills

Patients, 25%
Insurance Verification, 7%
Data Entry, 7%
Customer Service, 6%
Insurance Coverage, 5%
Computer System, 3%

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Insurance Claims Processor
Insurance Claims Processor vs Insurance Clerk

Updated January 8, 2025

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