Liability claims examiner vs claims benefit specialist

The differences between liability claims examiners and claims benefit specialists 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 claims benefit specialist. Additionally, a liability claims examiner has an average salary of $54,421, which is higher than the $47,292 average annual salary of a claims benefit specialist.

The top three skills for a liability claims examiner include party claims, litigation and claims handling. The most important skills for a claims benefit specialist are customer inquiries, appeals, and medical terminology.

Liability claims examiner vs claims benefit specialist overview

	Liability Claims Examiner	Claims Benefit Specialist
Yearly salary	$54,421	$47,292
Hourly rate	$26.16	$22.74
Growth rate	-6%	-6%
Number of jobs	13,734	32,208
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 40%
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 claims benefit specialist do?

Claims and benefits specialists ensure their company's compliance with the internal and external health plan partner processes. The job requires them to be sharp, organized, and able to multitask. They recommend strategies that will improve the processes present in the current trends that they constantly evaluate. These specialists manage portfolios of claims and benefits issues and ensure that they provide the best resolutions that follow the health plan processing guidelines to impress their clients.

Liability claims examiner vs claims benefit specialist salary

Liability claims examiners and claims benefit specialists have different pay scales, as shown below.

	Liability Claims Examiner	Claims Benefit Specialist
Average salary	$54,421	$47,292
Salary range	Between $34,000 And $85,000	Between $32,000 And $68,000
Highest paying City	Lansing, MI	-
Highest paying state	Washington	-
Best paying company	W. R. Berkley	-
Best paying industry	Insurance	-

Differences between liability claims examiner and claims benefit specialist education

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

	Liability Claims Examiner	Claims Benefit Specialist
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 40%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Liability claims examiner vs claims benefit specialist demographics

Here are the differences between liability claims examiners' and claims benefit specialists' demographics:

	Liability Claims Examiner	Claims Benefit Specialist
Average age	44	44
Gender ratio	Male, 46.0% Female, 54.0%	Male, 19.6% Female, 80.4%
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, 11.4% Unknown, 4.4% Hispanic or Latino, 16.9% Asian, 5.2% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between liability claims examiner and claims benefit specialist 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.

Claims benefit specialist example responsibilities.

Analyze, process and manage FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
Establish a working knowledge of CPT, ICD-9, HCPCS codes, terminology, member benefits and claim flow.
Process claims utilizing appropriate ICD-9, DSM-IV and HCPCS codes.
Analyze each claim and calculate percentages for both PPO and NON-PPO providers.
Understand CPT, HCPCS, ICD-9-CM and ICD-10-CM medical claims coding regulations and guidelines
Process Non-HMO and PPO paper and electronic claims in an accurate and time manner.

Liability claims examiner vs claims benefit specialist skills

Common liability claims examiner skills

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

Common claims benefit specialist skills

Customer Inquiries, 11%
Appeals, 7%
Medical Terminology, 6%
Routine Claims, 5%
CPT, 4%
Processing Issues, 4%

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Liability Claims Examiner
Liability Claims Examiner vs Claims Benefit Specialist

Updated January 8, 2025

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