Liability claims examiner vs medical claims analyst

The differences between liability claims examiners and medical claims analysts 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 medical claims analyst. Additionally, a liability claims examiner has an average salary of $54,421, which is higher than the $46,708 average annual salary of a medical claims analyst.

The top three skills for a liability claims examiner include party claims, litigation and claims handling. The most important skills for a medical claims analyst are medical terminology, medicaid, and medical insurance claims.

Liability claims examiner vs medical claims analyst overview

	Liability Claims Examiner	Medical Claims Analyst
Yearly salary	$54,421	$46,708
Hourly rate	$26.16	$22.46
Growth rate	-6%	-6%
Number of jobs	13,734	65,897
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 36%
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 medical claims analyst do?

A medical claims analyst audits or verifies medical claims in insurance companies. Medical claims analysts make sure that corporate reimbursement payments are accurate. Usually, they work at an office on a computer workstation. They receive Medicaid claims from specialty and medical providers for reimbursement. Their job includes the development of an enhanced procedure in handling difficult Medicare/Medicaid letters while complying with the set policies.

Liability claims examiner vs medical claims analyst salary

Liability claims examiners and medical claims analysts have different pay scales, as shown below.

	Liability Claims Examiner	Medical Claims Analyst
Average salary	$54,421	$46,708
Salary range	Between $34,000 And $85,000	Between $32,000 And $68,000
Highest paying City	Lansing, MI	Bridgewater, NJ
Highest paying state	Washington	New Jersey
Best paying company	W. R. Berkley	Montefiore Mount Vernon Hospital
Best paying industry	Insurance	Insurance

Differences between liability claims examiner and medical claims analyst education

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

	Liability Claims Examiner	Medical Claims Analyst
Most common degree	Bachelor's Degree, 73%	Bachelor's Degree, 36%
Most common major	Business	Business
Most common college	Stanford University	University of Pennsylvania

Liability claims examiner vs medical claims analyst demographics

Here are the differences between liability claims examiners' and medical claims analysts' demographics:

	Liability Claims Examiner	Medical Claims Analyst
Average age	44	44
Gender ratio	Male, 46.0% Female, 54.0%	Male, 14.2% Female, 85.8%
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, 16.4% Asian, 5.1% White, 62.4% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between liability claims examiner and medical claims analyst 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.

Medical claims analyst example responsibilities.

Manage cases by aggressively directing the litigation process.
Analyze incoming medical claims using ICD-9, CPT, HCPCS coding, and Medicare fee schedules.
Determine if claims are in compliance under patient benefit plans for payments using DRG regulations :
Review medical records to determine if the ICD-9, CPT codes and modifiers are processed correctly.
Adhere to the HIPAA privacy, security regulations, and maintain confidentiality of patient a business records.
Research medical claims issues in response to informational inquiries by accessing and interpreting EOB's and claims history.

Liability claims examiner vs medical claims analyst skills

Common liability claims examiner skills

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

Common medical claims analyst skills

Medical Terminology, 9%
Medicaid, 6%
Medical Insurance Claims, 6%
Customer Service, 6%
Data Entry, 6%
Patients, 5%

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Liability Claims Examiner
Liability Claims Examiner vs Medical Claims Analyst

Updated January 8, 2025

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