Referral coordinator vs claims coordinator

The differences between referral coordinators and claims coordinators can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 1-2 years to become a referral coordinator, becoming a claims coordinator takes usually requires 4-6 years. Additionally, a claims coordinator has an average salary of $38,620, which is higher than the $35,179 average annual salary of a referral coordinator.

The top three skills for a referral coordinator include patients, customer service and medical terminology. The most important skills for a claims coordinator are customer service, patients, and data entry.

Referral coordinator vs claims coordinator overview

	Referral Coordinator	Claims Coordinator
Yearly salary	$35,179	$38,620
Hourly rate	$16.91	$18.57
Growth rate	-8%	-6%
Number of jobs	65,934	27,332
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 31%	Bachelor's Degree, 48%
Average age	49	44
Years of experience	2	6

What does a referral coordinator do?

A referral coordinator works with insurance companies and care providers to share essential patient information and assists primarily in scheduling appointments and managing health insurance issues. As a referral coordinator, you will work directly with the patient, patient families, or even social workers, depending on the job and patient needs. Other job responsibilities include general administrative or clerical tasks such as setting up appointments for new and existing patients, verifying insurance information before appointments, and answering phone calls.

What does a claims coordinator do?

Claims coordinators are professionals who are responsible for coordinating activities that are related to handling and processing insurance claims for an organization. These coordinators must serve as liaison officer between the organization, insurance provider, and policyholders to communicate the status and eligibility for coverage for all relevant claims. They need to ensure that billing requirements are met by reviewing insurance claims. Claims coordinators must also answer all the inquiries of their clients while making recommendations to resolve any claim issues.

Referral coordinator vs claims coordinator salary

Referral coordinators and claims coordinators have different pay scales, as shown below.

	Referral Coordinator	Claims Coordinator
Average salary	$35,179	$38,620
Salary range	Between $27,000 And $44,000	Between $31,000 And $47,000
Highest paying City	Portland, ME	Federal Way, WA
Highest paying state	Maine	New Jersey
Best paying company	Horizon Laser Vision	Xcel Energy
Best paying industry	Health Care	Finance

Differences between referral coordinator and claims coordinator education

There are a few differences between a referral coordinator and a claims coordinator in terms of educational background:

	Referral Coordinator	Claims Coordinator
Most common degree	Bachelor's Degree, 31%	Bachelor's Degree, 48%
Most common major	Business	Business
Most common college	-	-

Referral coordinator vs claims coordinator demographics

Here are the differences between referral coordinators' and claims coordinators' demographics:

	Referral Coordinator	Claims Coordinator
Average age	49	44
Gender ratio	Male, 10.2% Female, 89.8%	Male, 24.6% Female, 75.4%
Race ratio	Black or African American, 9.6% Unknown, 3.8% Hispanic or Latino, 12.0% Asian, 3.8% White, 70.6% American Indian and Alaska Native, 0.4%	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	9%	10%

Differences between referral coordinator and claims coordinator duties and responsibilities

Referral coordinator example responsibilities.

Establish rapport with all PCP offices, hospital personnel, and manage care representatives.
Ensure CPT and ICD-9 coding are accurate and complete according to AMA's guidelines and for third party intermediaries.
Contact medical insurance companies and provide ICD-9 diagnosis and CPT procedure codes for patient's illness, condition or injury.
Apply ICD-9 and CPT-4 codes to complete referral requests online or via fax.
Conduct the entire office's EHR process and create a system to track old and new patient's records.
Incorporate core organizational values of quality, respect, integrity, partnership, and compassion in all activities and decisions.

Claims coordinator example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
Serve as point of contact for all legal issues relate to HIPAA.
Streamline audit procedures of TPA and maintain extremely high production rate which help in keeping staffing requirements lower.
Review and audit claims -Using correct CPT and DX codes -Denial reports -correct billing error, resubmitted claims for proper payment
Communicate with company management, injure workers/customers, medical providers and TPA, as necessary, regarding claim relate matters.

Referral coordinator vs claims coordinator skills

Common referral coordinator skills

Patients, 30%
Customer Service, 12%
Medical Terminology, 7%
Patient Care, 4%
Data Entry, 4%
EMR, 3%

Common claims coordinator skills

Customer Service, 23%
Patients, 9%
Data Entry, 8%
Phone Calls, 6%
Insurance Claims, 5%
Quality Standards, 4%

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Referral Coordinator
Referral Coordinator vs Claims Coordinator

Updated January 8, 2025

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