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Medical claims specialist vs records specialist

The differences between medical claims specialists and records specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a medical claims specialist and a records specialist. Additionally, a medical claims specialist has an average salary of $35,706, which is higher than the $33,273 average annual salary of a records specialist.

The top three skills for a medical claims specialist include customer service, patients and medicaid. The most important skills for a records specialist are customer service, data entry, and office equipment.

Medical claims specialist vs records specialist overview

Medical Claims SpecialistRecords Specialist
Yearly salary$35,706$33,273
Hourly rate$17.17$16.00
Growth rate11%11%
Number of jobs82,89728,647
Job satisfaction--
Most common degreeBachelor's Degree, 38%Bachelor's Degree, 47%
Average age4545
Years of experience1212

What does a medical claims specialist do?

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.

What does a records specialist do?

Records Specialists are administrative professionals who help manage the records of the company. These records may be physical documents or digital copies that are stored in a database. Records Specialists may assist in creating filing systems and knowledge management systems to ensure that the records they keep are easily accessible. They also keep an organized list or database of all the documents that are with them. Records Specialists are in charge of pulling up records upon the request of different departments or individuals. If they are working with physical copies, they ensure that these documents are returned to them. If they are working with digital copies, they ensure that the files they share are kept confidential. Records Specialists may also be in charge of analyzing trends and creating records-related reports.

Medical claims specialist vs records specialist salary

Medical claims specialists and records specialists have different pay scales, as shown below.

Medical Claims SpecialistRecords Specialist
Average salary$35,706$33,273
Salary rangeBetween $28,000 And $43,000Between $26,000 And $42,000
Highest paying CityAttleboro, MASan Mateo, CA
Highest paying stateConnecticutOregon
Best paying companyTotal Medical Personnel StaffingMt. San Antonio College
Best paying industryGovernmentGovernment

Differences between medical claims specialist and records specialist education

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

Medical Claims SpecialistRecords Specialist
Most common degreeBachelor's Degree, 38%Bachelor's Degree, 47%
Most common majorBusinessBusiness
Most common collegeUniversity of PennsylvaniaStanford University

Medical claims specialist vs records specialist demographics

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

Medical Claims SpecialistRecords Specialist
Average age4545
Gender ratioMale, 16.7% Female, 83.3%Male, 29.8% Female, 70.2%
Race ratioBlack 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, 8.9% Unknown, 4.2% Hispanic or Latino, 17.5% Asian, 8.5% White, 59.6% American Indian and Alaska Native, 1.3%
LGBT Percentage9%9%

Differences between medical claims specialist and records specialist duties and responsibilities

Medical claims specialist example responsibilities.

  • Apply Medicare, Medicaid billing guidelines to achieve maximum reimbursement.
  • Detail knowledge of medical coding; ICD-9, CPT and HCPCS codes.
  • Confirm coverage and work with private payers, commercial payers, Medicaid, and Medicare for reimbursement of provide medical services.
  • Research medical records, compliance requirements and explanations of benefits to resolve accounts payable for Medicare, Medicaid and commercial insurance.
  • Maintain strict confidentiality/privacy of patients' protect health information in accordance with HIPAA regulations.
  • Assist in educating new hires in HIPPA laws and training.
  • Show more

Records specialist example responsibilities.

  • Develop numerous SQL scripts/queries for monitoring and managing the system.
  • Manage thousands of cases for several firms with deadlines for depositions while ensuring accuracy, confidentiality, and HIPAA compliance.
  • Train and mentore employees in EDMS.
  • Process project records for retention in EDMS.
  • Represent DOJ at an ODNI language training conference.
  • Liaise with GIS group to resolve mapping issues.
  • Show more

Medical claims specialist vs records specialist skills

Common medical claims specialist skills
  • Customer Service, 14%
  • Patients, 9%
  • Medicaid, 7%
  • Medical Billing, 6%
  • Phone Calls, 6%
  • Medical Terminology, 5%
Common records specialist skills
  • Customer Service, 25%
  • Data Entry, 14%
  • Office Equipment, 5%
  • Word Processing, 5%
  • Database Systems, 5%
  • Management System, 5%

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