Liability claims representative vs claims adjudicator

The differences between liability claims representatives and claims adjudicators 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 representative and a claims adjudicator. Additionally, a liability claims representative has an average salary of $45,654, which is higher than the $44,556 average annual salary of a claims adjudicator.

The top three skills for a liability claims representative include litigation, claims handling and customer service. The most important skills for a claims adjudicator are medical terminology, CPT, and disability claims.

Liability claims representative vs claims adjudicator overview

	Liability Claims Representative	Claims Adjudicator
Yearly salary	$45,654	$44,556
Hourly rate	$21.95	$21.42
Growth rate	-6%	-6%
Number of jobs	13,563	12,413
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 81%	Bachelor's Degree, 57%
Average age	44	44
Years of experience	6	6

What does a liability claims representative do?

A liability claims representative works at insurance companies where they are in charge of processing and settling insurance claims, ensuring accurate and efficient client service. They are responsible for conducting assessments, reviewing reports from examiners, and tracking any discrepancies such as underpayment or overpayment, reporting them right away. There are also times when they must meet with clients and inspect damages, conduct interviews and evaluations, estimate and negotiate settlements with external parties, and coordinate with other professionals to gain insights. Moreover, a liability claims representative maintains an active communication line with staff, resolving issues in a timely manner.

What does a claims adjudicator do?

Claims adjudicators determine the amount of money an insurance policy owner is entitled to receive. Other names they are known for are claims adjusters and medical bill advocates. They investigate the claims filed and decide to deny, pay, or negotiate a settlement with the policyholder themselves or their representatives. The insurance companies that hire them provide insurances for property, casualty, and liability. To do their job well, they should be organized and understand how the insurance industry works.

Liability claims representative vs claims adjudicator salary

Liability claims representatives and claims adjudicators have different pay scales, as shown below.

	Liability Claims Representative	Claims Adjudicator
Average salary	$45,654	$44,556
Salary range	Between $33,000 And $61,000	Between $31,000 And $63,000
Highest paying City	Somerville, MA	Madison, WI
Highest paying state	New Jersey	New Jersey
Best paying company	The Travelers Companies	Evolent Health
Best paying industry	Insurance	Insurance

Differences between liability claims representative and claims adjudicator education

There are a few differences between a liability claims representative and a claims adjudicator in terms of educational background:

	Liability Claims Representative	Claims Adjudicator
Most common degree	Bachelor's Degree, 81%	Bachelor's Degree, 57%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Liability claims representative vs claims adjudicator demographics

Here are the differences between liability claims representatives' and claims adjudicators' demographics:

	Liability Claims Representative	Claims Adjudicator
Average age	44	44
Gender ratio	Male, 43.1% Female, 56.9%	Male, 23.1% Female, 76.9%
Race ratio	Black or African American, 11.5% Unknown, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 61.7% American Indian and Alaska Native, 0.5%	Black or African American, 10.5% Unknown, 4.5% Hispanic or Latino, 15.3% Asian, 6.1% White, 63.0% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between liability claims representative and claims adjudicator duties and responsibilities

Liability claims representative example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Investigate and conclude property and casualty liability claims including those in litigation with the highest overall production of the claims representatives.
Participate in arbitration hearings through writing contentions, compiling evidence and personally representing files.
Control expenses by developing and following resolutions and/or litigation plans to drive claim to resolution.
Facilitate training seminars for new employees to familiarize them with various corporate procedures including exposure recognition, fraud detection and arbitration.
Complete field inspection of losses including accurate scope of damages, photographic evidence collection, written estimates utilizing Xactimate estimating software.

Claims adjudicator example responsibilities.

Manage appeals and authorizations by examining information and performing necessary adjustments.
Handle claims processing utilizing knowledge of medical coding standards, including HCPCS, CPT, and ICD-9.
Calculate refunds or credit balances involving reprocessing for partial adjustments and correct the CPT and ICD-9 codes.
Maintain compliance with HIPAA guidelines and regulations
Adjudicate claims for Medicaid, Medicare, and ambulance billing.
Interpret and processes routine and complex claims per Medicaid industry standards.

Liability claims representative vs claims adjudicator skills

Common liability claims representative skills

Litigation, 9%
Claims Handling, 8%
Customer Service, 7%
Law Enforcement Agencies, 6%
Insurance Claims, 6%
Reservations, 6%

Common claims adjudicator skills

Medical Terminology, 9%
CPT, 8%
Disability Claims, 7%
Adjudicate Claims, 6%
Quality Standards, 6%
Medicaid, 5%

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Liability Claims Representative
Liability Claims Representative vs Claims Adjudicator

Updated January 8, 2025

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