Medical claims processor vs medical records clerk

The differences between medical claims processors and medical records clerks can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a medical claims processor, becoming a medical records clerk takes usually requires 6-12 months. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $32,491 average annual salary of a medical records clerk.

The top three skills for a medical claims processor include patients, healthcare and data entry. The most important skills for a medical records clerk are patients, customer service, and data entry.

Medical claims processor vs medical records clerk overview

	Medical Claims Processor	Medical Records Clerk
Yearly salary	$36,777	$32,491
Hourly rate	$17.68	$15.62
Growth rate	-3%	11%
Number of jobs	59,992	129,998
Job satisfaction	-	5
Most common degree	Bachelor's Degree, 29%	Associate Degree, 29%
Average age	44	45
Years of experience	4	12

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 a medical records clerk do?

Medical records clerks are employees in hospitals or clinics who manage office records. They are in charge of creating, updating, and filing patient-related medical records and other related documents. They ensure that all documents are correctly filled out and labeled before storing them safely in their respective storage areas. They may also be in charge of digitizing forms for easier access to files and back up purposes. They ensure that medical records are exact and updated. Medical records clerks should be organized and must always be on top of all tasks related to patient or medical records.

Medical claims processor vs medical records clerk salary

Medical claims processors and medical records clerks have different pay scales, as shown below.

	Medical Claims Processor	Medical Records Clerk
Average salary	$36,777	$32,491
Salary range	Between $29,000 And $45,000	Between $25,000 And $40,000
Highest paying City	Dover, DE	Rochester, NY
Highest paying state	Delaware	Alaska
Best paying company	Cognizant	University of California, Berkeley
Best paying industry	Government	Health Care

Differences between medical claims processor and medical records clerk education

There are a few differences between a medical claims processor and a medical records clerk in terms of educational background:

	Medical Claims Processor	Medical Records Clerk
Most common degree	Bachelor's Degree, 29%	Associate Degree, 29%
Most common major	Business	Health Care Administration
Most common college	-	University of Pennsylvania

Medical claims processor vs medical records clerk demographics

Here are the differences between medical claims processors' and medical records clerks' demographics:

	Medical Claims Processor	Medical Records Clerk
Average age	44	45
Gender ratio	Male, 16.0% Female, 84.0%	Male, 13.1% Female, 86.9%
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, 9.2% Unknown, 4.2% Hispanic or Latino, 17.3% Asian, 7.8% White, 60.2% American Indian and Alaska Native, 1.3%
LGBT Percentage	11%	9%

Differences between medical claims processor and medical records clerk 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.

Medical records clerk example responsibilities.

Manage transition from in-house transcription system to outsource transcription service.
Manage front office check-in, insurance verification and certifications from doctors.
Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Perform infant labs and update the system with results, triage incoming patients, perform necessary resuscitation to baby and mom.
Provide information to medical facilities and patients when necessary and respond to subpoenas and other general release of patient information.
Experience in CPT and ICD-10 coding.

Medical claims processor vs medical records clerk skills

Common medical claims processor skills

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

Common medical records clerk skills

Patients, 27%
Customer Service, 9%
Data Entry, 7%
Medical Terminology, 6%
HIPAA, 5%
Patient Care, 4%

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Medical Claims Processor
Medical Claims Processor vs Medical Records Clerk

Updated January 8, 2025

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