Medical claims examiner vs auto claims adjuster

The differences between medical claims examiners and auto claims adjusters can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 4-6 years to become a medical claims examiner, becoming an auto claims adjuster takes usually requires 2-4 years. Additionally, an auto claims adjuster has an average salary of $52,621, which is higher than the $42,773 average annual salary of a medical claims examiner.

The top three skills for a medical claims examiner include medical terminology, customer service and data entry. The most important skills for an auto claims adjuster are repair process, body shop, and strong customer service.

Medical claims examiner vs auto claims adjuster overview

	Medical Claims Examiner	Auto Claims Adjuster
Yearly salary	$42,773	$52,621
Hourly rate	$20.56	$25.30
Growth rate	-6%	-6%
Number of jobs	57,125	16,187
Job satisfaction	5	-
Most common degree	Bachelor's Degree, 36%	Bachelor's Degree, 72%
Average age	44	44
Years of experience	6	4

What does a medical claims examiner do?

A medical claims examiner determines whether an insurer will be covering losses from accidents and illness. They are responsible for evaluating insurance claims and applications, following up with insurance adjusters to protect an insurer from financial loss, ensuring information integrity, and ensuring standard guidelines are adhered to. They are also tasked with approving payment and facilitating additional investigation. Qualifications for this position include knowledge of medical terminology.

What does an auto claims adjuster do?

A claims adjuster inspects insurance claim liability for property damage or personal injuries and calculates payments. They can either work in-house for insurance companies or as external freelancers. They collect gathered information from different reliable sources to determine insurance obligations based on the degree of damage caused. It is part of their responsibility to interview claimants and witnesses and refer with experts like engineers or policyholders to estimate the damage and if it's covered by insurance policies.

Medical claims examiner vs auto claims adjuster salary

Medical claims examiners and auto claims adjusters have different pay scales, as shown below.

	Medical Claims Examiner	Auto Claims Adjuster
Average salary	$42,773	$52,621
Salary range	Between $30,000 And $59,000	Between $38,000 And $71,000
Highest paying City	Los Angeles, CA	Jersey City, NJ
Highest paying state	New Jersey	Alaska
Best paying company	UST Global	EMC Insurance
Best paying industry	Technology	Insurance

Differences between medical claims examiner and auto claims adjuster education

There are a few differences between a medical claims examiner and an auto claims adjuster in terms of educational background:

	Medical Claims Examiner	Auto Claims Adjuster
Most common degree	Bachelor's Degree, 36%	Bachelor's Degree, 72%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Medical claims examiner vs auto claims adjuster demographics

Here are the differences between medical claims examiners' and auto claims adjusters' demographics:

	Medical Claims Examiner	Auto Claims Adjuster
Average age	44	44
Gender ratio	Male, 16.6% Female, 83.4%	Male, 52.2% Female, 47.8%
Race ratio	Black or African American, 10.5% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 62.4% American Indian and Alaska Native, 0.5%	Black or African American, 12.1% Unknown, 4.4% Hispanic or Latino, 16.3% Asian, 5.1% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between medical claims examiner and auto claims adjuster duties and responsibilities

Medical claims examiner example responsibilities.

Manage cases by aggressively directing the litigation process.
Process medical facility claims payment according to account-specific contract (HMO, PPO, EPO, etc . )
Process PPO, HMO, comprehensive plans, including medicare supplements, hospital, chiropractic and physical therapy claims.
Identify which claims are eligible for PPO reprising.
Resolve medical claims by approving and/or denying base on CMS guidelines for Medicaid/Medicare claim processing.
Verify that all ICD-9, CPT, modifiers and revenue codes are used correctly, prior to payment approval.

Auto claims adjuster example responsibilities.

Manage file inventory by utilizing CCC pathways diary system documenting claim file activities in accordance with establish procedures
Work closely with staff attorneys to develop litigation strategies and prepare for depositions.
Provide feedback and implement strategies on claim investigation, reserving, settlement and litigation.
Research and review delinquent mortgage cases, financial scenarios and individual homeowner situations to develop solutions compliant with investor policy.
Prepare written arguments for arbitration and provide all supporting documentation and evidence.
Compile and submit arbitration applications against the insurers of at-fault parties who refuse liability.

Medical claims examiner vs auto claims adjuster skills

Common medical claims examiner skills

Medical Terminology, 10%
Customer Service, 9%
Data Entry, 7%
Medical Treatment, 5%
Computer System, 5%
Provider Contracts, 4%

Common auto claims adjuster skills

Repair Process, 14%
Body Shop, 10%
Strong Customer Service, 9%
Vehicle Inspections, 8%
Insurance Claims, 7%
Customer Service, 5%

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Medical Claims Examiner
Medical Claims Examiner vs Auto Claims Adjuster

Updated January 8, 2025

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