Litigation claim representative vs claims adjudicator

The differences between litigation claim 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 litigation claim representative and a claims adjudicator. Additionally, a litigation claim representative has an average salary of $59,381, which is higher than the $44,556 average annual salary of a claims adjudicator.

The top three skills for a litigation claim representative include litigation, defense counsel and product liability. The most important skills for a claims adjudicator are medical terminology, CPT, and disability claims.

Litigation claim representative vs claims adjudicator overview

	Litigation Claim Representative	Claims Adjudicator
Yearly salary	$59,381	$44,556
Hourly rate	$28.55	$21.42
Growth rate	-6%	-6%
Number of jobs	6,570	12,413
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 66%	Bachelor's Degree, 57%
Average age	44	44
Years of experience	6	6

Litigation claim representative vs claims adjudicator salary

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

	Litigation Claim Representative	Claims Adjudicator
Average salary	$59,381	$44,556
Salary range	Between $45,000 And $76,000	Between $31,000 And $63,000
Highest paying City	-	Madison, WI
Highest paying state	-	New Jersey
Best paying company	-	Evolent Health
Best paying industry	-	Insurance

Differences between litigation claim representative and claims adjudicator education

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

	Litigation Claim Representative	Claims Adjudicator
Most common degree	Bachelor's Degree, 66%	Bachelor's Degree, 57%
Most common major	Business	Business
Most common college	Bentley University	Stanford University

Litigation claim representative vs claims adjudicator demographics

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

	Litigation Claim Representative	Claims Adjudicator
Average age	44	44
Gender ratio	Male, 48.4% Female, 51.6%	Male, 23.1% Female, 76.9%
Race ratio	Black or African American, 11.8% Unknown, 4.4% Hispanic or Latino, 16.6% Asian, 5.2% White, 61.6% 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 litigation claim representative and claims adjudicator duties and responsibilities

Litigation claim representative example responsibilities.

Manage assigned third party administration (TPA) multi-jurisdictional workers' compensation; subrogation recovery claims; assign defense attorney.
Resolve no-fault disputes in the arbitration forum and court system in accordance with no-fault regulation and laws.
Guide defense counsel throughout litigation process, securing compliance with corporate objectives and guidelines.
Assist in depositions and interrogatories of inspectors.
Review summons and complaints receive from medical providers attorneys.
Monitor closely and provide directive on every case through litigation till resolution are reached.

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.

Litigation claim representative vs claims adjudicator skills

Common litigation claim representative skills

Litigation, 31%
Defense Counsel, 10%
Product Liability, 8%
Settlement Conferences, 6%
Litigation Process, 5%
ISO, 5%

Common claims adjudicator skills

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

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Litigation Claim Representative
Litigation Claim Representative vs Claims Adjudicator

Updated January 8, 2025

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