Medical claims analyst vs liability claims representative

The differences between medical claims analysts and liability claims representatives can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a medical claims analyst and a liability claims representative. Additionally, a medical claims analyst has an average salary of $46,708, which is higher than the $45,654 average annual salary of a liability claims representative.

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

Medical claims analyst vs liability claims representative overview

	Medical Claims Analyst	Liability Claims Representative
Yearly salary	$46,708	$45,654
Hourly rate	$22.46	$21.95
Growth rate	-6%	-6%
Number of jobs	65,897	13,563
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 36%	Bachelor's Degree, 81%
Average age	44	44
Years of experience	6	6

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.

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.

Medical claims analyst vs liability claims representative salary

Medical claims analysts and liability claims representatives have different pay scales, as shown below.

	Medical Claims Analyst	Liability Claims Representative
Average salary	$46,708	$45,654
Salary range	Between $32,000 And $68,000	Between $33,000 And $61,000
Highest paying City	Bridgewater, NJ	Somerville, MA
Highest paying state	New Jersey	New Jersey
Best paying company	Montefiore Mount Vernon Hospital	The Travelers Companies
Best paying industry	Insurance	Insurance

Differences between medical claims analyst and liability claims representative education

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

	Medical Claims Analyst	Liability Claims Representative
Most common degree	Bachelor's Degree, 36%	Bachelor's Degree, 81%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Medical claims analyst vs liability claims representative demographics

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

	Medical Claims Analyst	Liability Claims Representative
Average age	44	44
Gender ratio	Male, 14.2% Female, 85.8%	Male, 43.1% Female, 56.9%
Race ratio	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%	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%
LGBT Percentage	10%	10%

Differences between medical claims analyst and liability claims representative duties and responsibilities

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 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.

Medical claims analyst vs liability claims representative skills

Common medical claims analyst skills

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

Common liability claims representative skills

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

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Medical Claims Analyst
Medical Claims Analyst vs Liability Claims Representative

Updated January 8, 2025

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