Liability claims examiner vs claim processor

The differences between liability claims examiners and claim processors can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a liability claims examiner and a claim processor. Additionally, a liability claims examiner has an average salary of $54,421, which is higher than the $41,201 average annual salary of a claim processor.

The top three skills for a liability claims examiner include party claims, litigation and claims handling. The most important skills for a claim processor are customer service, data entry, and medical terminology.

Liability claims examiner vs claim processor overview

	Liability Claims Examiner	Claim Processor
Yearly salary	$54,421	$41,201
Hourly rate	$26.16	$19.81
Growth rate	-6%	-6%
Number of jobs	13,734	11,542
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 43%
Average age	44	44
Years of experience	6	6

What does a liability claims examiner do?

A Liability Claims Examiner or also known as an Insurance investigator, is a person who monitors and reviews settled insurances. They will determine if the paid amount is in accordance with the corporation or company's procedure. They report possible irregularities that are happening, like underpayment and overpayment of insurances. They also evaluate insurance claims or applications and do a follow-up of the status to protect and secure the clients from having a financial loss.

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.

Liability claims examiner vs claim processor salary

Liability claims examiners and claim processors have different pay scales, as shown below.

	Liability Claims Examiner	Claim Processor
Average salary	$54,421	$41,201
Salary range	Between $34,000 And $85,000	Between $26,000 And $62,000
Highest paying City	Lansing, MI	Columbia, MD
Highest paying state	Washington	Connecticut
Best paying company	W. R. Berkley	NTT Data International L.L.C.
Best paying industry	Insurance	Insurance

Differences between liability claims examiner and claim processor education

There are a few differences between a liability claims examiner and a claim processor in terms of educational background:

	Liability Claims Examiner	Claim Processor
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 43%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Liability claims examiner vs claim processor demographics

Here are the differences between liability claims examiners' and claim processors' demographics:

	Liability Claims Examiner	Claim Processor
Average age	44	44
Gender ratio	Male, 46.0% Female, 54.0%	Male, 22.9% Female, 77.1%
Race ratio	Black or African American, 11.1% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.1% White, 62.6% 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	10%	10%

Differences between liability claims examiner and claim processor duties and responsibilities

Liability claims examiner example responsibilities.

Handle automobile liability, general liability, products liability and manage litigation for one specific client.
Manage strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
Oversee adjustment of all third-party liability losses, coverage assessment, investigation, and evaluations regarding litigation claims.
Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
Interact with assign counsel for case status, interrogatories and preparation for trials on calendar.
Investigate and identify fraud claims and partner with SIU for additional investigations to prevent payouts after fraud are proven.

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.

Liability claims examiner vs claim processor skills

Common liability claims examiner skills

Party Claims, 12%
Litigation, 12%
Claims Handling, 11%
Claims Process, 11%
Policy Coverage, 10%
Coverage Analysis, 9%

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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Liability Claims Examiner
Liability Claims Examiner vs Claim Processor

Updated January 8, 2025

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