Insurance verifier vs patient care representative

The differences between insurance verifiers and patient care representatives 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 verifier and a patient care representative. Additionally, a patient care representative has an average salary of $33,709, which is higher than the $33,450 average annual salary of an insurance verifier.

The top three skills for an insurance verifier include patients, insurance verification and medical terminology. The most important skills for a patient care representative are patients, patient care, and home health.

Insurance verifier vs patient care representative overview

	Insurance Verifier	Patient Care Representative
Yearly salary	$33,450	$33,709
Hourly rate	$16.08	$16.21
Growth rate	-3%	-4%
Number of jobs	84,023	133,317
Job satisfaction	-	-
Most common degree	Associate Degree, 25%	Bachelor's Degree, 39%
Average age	44	40
Years of experience	4	4

What does an insurance verifier do?

An insurance verifier specializes in dealing with the billing process and patient claims. As the process begins, insurance verifiers look into patient insurance information and verify treatments that their policies cover. They call the insurance companies and send proper documentation to verify pre-approval for the required procedure. Eventually, the insurance verifiers work with insurance companies to bill them for the procedure. Their tasks may also include communicating with patients about benefits, coverage, and care authorization, and liaising with patients and providers to communicate their needs and current state.

What does a patient care representative do?

PCRs (Patient Care Representatives) are given responsibilities like updating and verifying patient information after every visit, scheduling and reminding patients about appointments, and informing patients about delays and how long the estimated waiting times will be. They are also responsible for obtaining patients' personal information like their address, contact details, insurance information, and medical and surgical history. They must be able to communicate with patients, family members, and medical staff to give them all the information they need to treat the person looking for medical help.

Insurance verifier vs patient care representative salary

Insurance verifiers and patient care representatives have different pay scales, as shown below.

	Insurance Verifier	Patient Care Representative
Average salary	$33,450	$33,709
Salary range	Between $27,000 And $40,000	Between $27,000 And $41,000
Highest paying City	-	Boston, MA
Highest paying state	-	Alaska
Best paying company	-	Massachusetts General Hospital
Best paying industry	-	Technology

Differences between insurance verifier and patient care representative education

There are a few differences between an insurance verifier and a patient care representative in terms of educational background:

	Insurance Verifier	Patient Care Representative
Most common degree	Associate Degree, 25%	Bachelor's Degree, 39%
Most common major	Health Care Administration	Business
Most common college	-	University of Pennsylvania

Insurance verifier vs patient care representative demographics

Here are the differences between insurance verifiers' and patient care representatives' demographics:

	Insurance Verifier	Patient Care Representative
Average age	44	40
Gender ratio	Male, 10.5% Female, 89.5%	Male, 17.1% Female, 82.9%
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, 12.5% Unknown, 5.1% Hispanic or Latino, 20.3% Asian, 6.3% White, 55.2% American Indian and Alaska Native, 0.6%
LGBT Percentage	11%	7%

Differences between insurance verifier and patient care representative duties and responsibilities

Insurance verifier example responsibilities.

Manage database by processing renewals and endorsements.
Verify eligibility for members who have Medicaid and Medicare.
Verify and process demographic information and insurance benefits to register inpatients, outpatients, short procedures, and emergency room patients.
Handle a substantial amount of Allstate customers, third party carriers, and others who need assistance to file a claim.

Patient care representative example responsibilities.

Manage cash and co-payments accurately and discharge patients providing them with proper medical notes and information before exiting.
Verify insurance, Medicaid, Medicare, register patients, and code proper ICD-9 and CPT codes on encounters.
Utilize medical terminology, CPT, HCPC and ICD-9 and patient information into new authorizations.
Interview patients to gather information pertinent to their Medicaid application.
Screen, identify, and enter ICD-9 coding from treatment record forms.
Maintain patient confidentiality and follow HIPAA rules.

Insurance verifier vs patient care representative skills

Common insurance verifier skills

Patients, 25%
Insurance Verification, 9%
Medical Terminology, 9%
Customer Service, 7%
Data Entry, 5%
Insurance Eligibility, 4%

Common patient care representative skills

Patients, 25%
Patient Care, 13%
Home Health, 7%
Cash Management, 5%
Phone Calls, 4%
CPT, 3%

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Office and Administrative Industry
Insurance Verifier
Insurance Verifier vs Patient Care Representative

Updated January 8, 2025

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