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Medical insurance coder vs medical claims processor

The differences between medical insurance coders and medical claims processors can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 1-2 years to become a medical insurance coder, becoming a medical claims processor takes usually requires 2-4 years. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $32,709 average annual salary of a medical insurance coder.

The top three skills for a medical insurance coder include patients, insurance verification and medicaid. The most important skills for a medical claims processor are patients, healthcare, and data entry.

Medical insurance coder vs medical claims processor overview

Medical Insurance CoderMedical Claims Processor
Yearly salary$32,709$36,777
Hourly rate$15.73$17.68
Growth rate-3%-3%
Number of jobs81,02859,992
Job satisfaction--
Most common degreeAssociate Degree, 33%Bachelor's Degree, 29%
Average age4644
Years of experience24

Medical insurance coder vs medical claims processor salary

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

Medical Insurance CoderMedical Claims Processor
Average salary$32,709$36,777
Salary rangeBetween $27,000 And $38,000Between $29,000 And $45,000
Highest paying City-Dover, DE
Highest paying state-Delaware
Best paying company-Cognizant
Best paying industry-Government

Differences between medical insurance coder and medical claims processor education

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

Medical Insurance CoderMedical Claims Processor
Most common degreeAssociate Degree, 33%Bachelor's Degree, 29%
Most common majorHealth Care AdministrationBusiness
Most common collegeUniversity of Pennsylvania-

Medical insurance coder vs medical claims processor demographics

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

Medical Insurance CoderMedical Claims Processor
Average age4644
Gender ratioMale, 10.8% Female, 89.2%Male, 16.0% Female, 84.0%
Race ratioBlack or African American, 12.1% Unknown, 4.3% Hispanic or Latino, 18.1% Asian, 6.8% White, 57.9% American Indian and Alaska Native, 0.8%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 Percentage7%11%

Differences between medical insurance coder and medical claims processor duties and responsibilities

Medical insurance coder example responsibilities.

  • Assign to PacifiCare of Washington a medical insurance manage care plan (HMO).
  • Manage chart completion (ICD-9-CM and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
  • Maintain and update ICD-9, CPT-4 & HCPCS coding for practice.
  • Bill major insurance carriers and Medicaid using ICD-9 and CPT codes.
  • Deliver explanation of insurance coverage and patient responsibilities to patients base on their policy.
  • Determine diagnosis and E/M level.
    • Show more

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.
    • Show more

Medical insurance coder vs medical claims processor skills

Common medical insurance coder skills
  • Patients, 19%
  • Insurance Verification, 11%
  • Medicaid, 6%
  • Patient Accounts, 5%
  • Customer Service, 5%
  • Medical Insurance Claims, 5%
Common medical claims processor skills
  • Patients, 13%
  • Healthcare, 10%
  • Data Entry, 10%
  • Medical Insurance Claims, 9%
  • Medical Terminology, 6%
  • Customer Service, 3%

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Updated January 8, 2025

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