Insurance processor vs claim processor

The differences between insurance processors and claim processors 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 processor, becoming a claim processor takes usually requires 4-6 years. Additionally, a claim processor has an average salary of $41,201, which is higher than the $33,041 average annual salary of an insurance processor.

The top three skills for an insurance processor include data entry, customer service and phone calls. The most important skills for a claim processor are customer service, data entry, and medical terminology.

Insurance processor vs claim processor overview

	Insurance Processor	Claim Processor
Yearly salary	$33,041	$41,201
Hourly rate	$15.89	$19.81
Growth rate	-3%	-6%
Number of jobs	50,523	11,542
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 33%	Bachelor's Degree, 43%
Average age	44	44
Years of experience	4	6

What does an insurance processor do?

Insurance Processors deal with the processing of insurance applications, amendments of policies, changes, and cancellations. An Insurance Processor works with the client to choose the best insurance package and advise them on how to maximize their benefits. Clients need to understand the insurance process by answering inquiries. It is also essential that an Insurance Processor work hand in hand with the client, guiding them through the process, explaining all crucial parts of the insurance to establish trust in you and the company.

What does a claim processor do?

A Claims Processor is responsible for processing and verifying insurance claims, in adherence to the policies, laws, and regulations of the company involved. Aside from examining its authenticity, they must also oversee new policies and recommend modifications should it be needed. Moreover, it is also the task of the Claims Processor to prepare the necessary documents and guidelines for the policyholder, process reimbursements upon approval, provide answers to inquiries, and report issues and updates to the management.

Insurance processor vs claim processor salary

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

	Insurance Processor	Claim Processor
Average salary	$33,041	$41,201
Salary range	Between $28,000 And $38,000	Between $26,000 And $62,000
Highest paying City	Leawood, KS	Columbia, MD
Highest paying state	Connecticut	Connecticut
Best paying company	Moore County Hospital District	NTT Data International L.L.C.
Best paying industry	Finance	Insurance

Differences between insurance processor and claim processor education

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

	Insurance Processor	Claim Processor
Most common degree	Bachelor's Degree, 33%	Bachelor's Degree, 43%
Most common major	Business	Business
Most common college	-	Stanford University

Insurance processor vs claim processor demographics

Here are the differences between insurance processors' and claim processors' demographics:

	Insurance Processor	Claim Processor
Average age	44	44
Gender ratio	Male, 16.3% Female, 83.7%	Male, 22.9% Female, 77.1%
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, 16.7% Asian, 5.2% White, 62.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	10%

Differences between insurance processor and claim processor duties and responsibilities

Insurance processor example responsibilities.

Manage database by processing renewals and endorsements.
Input and process all dental claims, through electronic and paper submission, to private insurance companies and Medicaid.
Maintain patient privacy and confidentiality complaint with HIPPA regulations.
Work directly with mortgage lenders and foreclosure attorneys to negotiate timely and cost effective repayment plans or modifications for delinquent loans.
Handle a substantial amount of Allstate customers, third party carriers, and others who need assistance to file a claim.

Claim processor example responsibilities.

Experience in many facets of the managed healthcare insurance business.
Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
Use ICD-9, CPT-4 and other medical manuals to adjudicate claims.
Analyze claims submit by providers and facilities for appropriate ICD-9, CPT and HCPCS codes against charges that are being bill.
Call DME and HME companies to correct invoices.
Coach and assist in the training of new EMR databases.

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Insurance processor vs claim processor skills

Common insurance processor skills

Data Entry, 18%
Customer Service, 12%
Phone Calls, 9%
Outbound Calls, 9%
Insurance Claims, 6%
Insurance Coverage, 5%

Common claim processor skills

Customer Service, 20%
Data Entry, 8%
Medical Terminology, 5%
CPT, 5%
Claims Processing, 4%
Medical Insurance Claims, 4%

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Updated January 8, 2025

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