Medical claims processor vs insurance coordinator

The differences between medical claims processors and insurance coordinators can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both a medical claims processor and an insurance coordinator. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $32,788 average annual salary of an insurance coordinator.

The top three skills for a medical claims processor include patients, healthcare and data entry. The most important skills for an insurance coordinator are patients, customer service, and insurance verification.

Medical claims processor vs insurance coordinator overview

	Medical Claims Processor	Insurance Coordinator
Yearly salary	$36,777	$32,788
Hourly rate	$17.68	$15.76
Growth rate	-3%	-3%
Number of jobs	59,992	108,509
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 29%	Bachelor's Degree, 36%
Average age	44	44
Years of experience	4	4

What does a medical claims processor do?

A medical claims processor has working knowledge of medical billing and coding. The qualifications for this position include knowledge of current procedural terminology (CPT) and international classification of diseases (ICD) coding systems. They are responsible for processing claims forms, adjudicating the allocation of deductibles and copays, and following through with adjudication policies to facilitate proper payment of claims.

What does an insurance coordinator do?

An insurance coordinator is responsible for evaluating and validating insurance information to verify claims and process the necessary claims resolutions for parties. Insurance coordinators submit claims statements timely to the insurance officers for review, coordinate with the clients for inquiries and updates, and reach out to medical institutions for accurate filing of payments. An insurance coordinator must have excellent communication and analytical skills to assess reports, resolve claims discrepancies, and escalate high-level complaints to the officers for immediate action.

Medical claims processor vs insurance coordinator salary

Medical claims processors and insurance coordinators have different pay scales, as shown below.

	Medical Claims Processor	Insurance Coordinator
Average salary	$36,777	$32,788
Salary range	Between $29,000 And $45,000	Between $25,000 And $41,000
Highest paying City	Dover, DE	Oakland, CA
Highest paying state	Delaware	New Hampshire
Best paying company	Cognizant	University of California, Berkeley
Best paying industry	Government	Pharmaceutical

Differences between medical claims processor and insurance coordinator education

There are a few differences between a medical claims processor and an insurance coordinator in terms of educational background:

	Medical Claims Processor	Insurance Coordinator
Most common degree	Bachelor's Degree, 29%	Bachelor's Degree, 36%
Most common major	Business	Business
Most common college	-	-

Medical claims processor vs insurance coordinator demographics

Here are the differences between medical claims processors' and insurance coordinators' demographics:

	Medical Claims Processor	Insurance Coordinator
Average age	44	44
Gender ratio	Male, 16.0% Female, 84.0%	Male, 9.9% Female, 90.1%
Race ratio	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	11%

Differences between medical claims processor and insurance coordinator duties and responsibilities

Medical claims processor example responsibilities.

Enter UB 92 and 1500 HCFA medical claims into computer system manage and process insurance claims.
Manage cases by aggressively directing the litigation process.
Submit medical claims to commercial insurance companies, Medicare, and Medicaid for payment with use of ICD-9 and CPT coding.
Review and verify patient account information against insurance program specifications, analyze surgical procedures and diagnoses using CPT-4 and ICD-9 codes.
Acknowledge and enforces confidentiality in alignment with (HIPPA) guidelines.
Audit encounters and ICD-10 codes to ensure correct coding and maximum reimbursement.

Insurance coordinator example responsibilities.

Verify patient dental insurance coverage and limitations with major private and business dental insurance providers as well as Medicaid and Medicare.
File to record patient demographics in numerous EMR systems and paper charts if applicable.
Prepare providers and staff for ICD-10 transition.
Post and reconcile all daily insurance, patient payments and transactions within the EMR system.
Experience in registration in healthcare, business office and physician billing, with reimbursement and collections.
Process all Medicare claims, explaining HMO changes to patients in detail and accurately documenting all benefits.

Medical claims processor vs insurance coordinator skills

Common medical claims processor skills

Patients, 13%
Healthcare, 10%
Data Entry, 10%
Medical Insurance Claims, 9%
Medical Terminology, 6%
Customer Service, 3%

Common insurance coordinator skills

Patients, 26%
Customer Service, 11%
Insurance Verification, 7%
Insurance Eligibility, 4%
Medicaid, 3%
Medical Terminology, 3%

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Medical Claims Processor
Medical Claims Processor vs Insurance Coordinator

Updated January 8, 2025

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