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The differences between medical claims specialists and insurance verification specialists can be seen in a few details. Each job has different responsibilities and duties. Additionally, a medical claims specialist has an average salary of $35,706, which is higher than the $33,043 average annual salary of an insurance verification specialist.
The top three skills for a medical claims specialist include customer service, patients and medicaid. The most important skills for an insurance verification specialist are patients, insurance verification, and customer service.
| Medical Claims Specialist | Insurance Verification Specialist | |
| Yearly salary | $35,706 | $33,043 |
| Hourly rate | $17.17 | $15.89 |
| Growth rate | 11% | 6% |
| Number of jobs | 82,897 | 71,688 |
| Job satisfaction | - | - |
| Most common degree | Bachelor's Degree, 38% | Associate Degree, 27% |
| Average age | 45 | 46 |
| Years of experience | 12 | - |
A medical claims specialist is responsible for gathering and processing the information required to complete the medical insurance claims process. Typical duties include determining covered medical insurance losses, documenting medical claims actions, and resolving claims through approval or denial of documentation. In addition, you will be responsible for maintaining excellent customer service by responding to customer inquiries and following best practices. You will also be responsible for protecting company operations by maintaining the confidentiality of information.
An insurance verification specialist is responsible for confirming a patient's insurance details and eligibility to receive medical care services. Insurance verification specialists review the insurance documents of the patients, including its coverage and limitations, and escalate concerns to the supervisor for immediate resolution. They process paperwork accordingly upon coordinating with the patients and attending health professionals. An insurance verification specialist must have excellent communication and organizational skills, finishing administrative tasks efficiently under minimal supervision.
Medical claims specialists and insurance verification specialists have different pay scales, as shown below.
| Medical Claims Specialist | Insurance Verification Specialist | |
| Average salary | $35,706 | $33,043 |
| Salary range | Between $28,000 And $43,000 | Between $28,000 And $37,000 |
| Highest paying City | Attleboro, MA | Madison, WI |
| Highest paying state | Connecticut | New Hampshire |
| Best paying company | Total Medical Personnel Staffing | St. Luke's Cataract & Laser Institute |
| Best paying industry | Government | Pharmaceutical |
There are a few differences between a medical claims specialist and an insurance verification specialist in terms of educational background:
| Medical Claims Specialist | Insurance Verification Specialist | |
| Most common degree | Bachelor's Degree, 38% | Associate Degree, 27% |
| Most common major | Business | Health Care Administration |
| Most common college | University of Pennsylvania | University of Pennsylvania |
Here are the differences between medical claims specialists' and insurance verification specialists' demographics:
| Medical Claims Specialist | Insurance Verification Specialist | |
| Average age | 45 | 46 |
| Gender ratio | Male, 16.7% Female, 83.3% | Male, 11.4% Female, 88.6% |
| Race ratio | Black or African American, 9.5% Unknown, 4.2% Hispanic or Latino, 17.0% Asian, 8.3% White, 59.8% American Indian and Alaska Native, 1.3% | Black or African American, 9.3% Unknown, 3.6% Hispanic or Latino, 16.0% Asian, 4.9% White, 66.1% American Indian and Alaska Native, 0.1% |
| LGBT Percentage | 9% | 7% |