Reimbursement analyst vs claims analyst

The differences between reimbursement analysts and claims analysts can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 6-12 months to become a reimbursement analyst, becoming a claims analyst takes usually requires 4-6 years. Additionally, a reimbursement analyst has an average salary of $65,489, which is higher than the $48,398 average annual salary of a claims analyst.

The top three skills for a reimbursement analyst include patients, medicare and medicaid. The most important skills for a claims analyst are customer service, medical terminology, and CPT.

Reimbursement analyst vs claims analyst overview

	Reimbursement Analyst	Claims Analyst
Yearly salary	$65,489	$48,398
Hourly rate	$31.49	$23.27
Growth rate	11%	-6%
Number of jobs	10,216	22,062
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 52%
Average age	45	44
Years of experience	12	6

What does a reimbursement analyst do?

A reimbursement analyst is responsible for determining patients' billing statements and approving reimbursement claims. Reimbursement analysts review reimbursement requests, respond to patients' inquiries and concerns, and resolve billing discrepancies. They also validate patients' information and medical documents to support claims and process reimbursement efficiently. A reimbursement analyst must have excellent analytical and communication skills, as well as have extensive knowledge of the reimbursement policies and procedures to release payments and manage the patients' eligibility for reimbursement.

What does a claims analyst do?

A claims analyst specializes in processing medical insurance claims. They are primarily responsible for verifying the authenticity and eligibility of claims, analyzing the billing, communicating with policyholders, and ensuring adherence to all the policies and regulations during the entire procedure. Furthermore, a claims analyst is also in charge of administrative tasks such as keeping and updating records, reaching out and sending reports to creditors, setting appointments and schedules, processing paperwork, coordinating with key personnel, and discussing terms and necessary information to clients.

Reimbursement analyst vs claims analyst salary

Reimbursement analysts and claims analysts have different pay scales, as shown below.

	Reimbursement Analyst	Claims Analyst
Average salary	$65,489	$48,398
Salary range	Between $48,000 And $87,000	Between $29,000 And $78,000
Highest paying City	Quincy, MA	Trenton, NJ
Highest paying state	Massachusetts	New Jersey
Best paying company	Tufts Health Plan	Google
Best paying industry	Pharmaceutical	-

Differences between reimbursement analyst and claims analyst education

There are a few differences between a reimbursement analyst and a claims analyst in terms of educational background:

	Reimbursement Analyst	Claims Analyst
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 52%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Reimbursement analyst vs claims analyst demographics

Here are the differences between reimbursement analysts' and claims analysts' demographics:

	Reimbursement Analyst	Claims Analyst
Average age	45	44
Gender ratio	Male, 27.4% Female, 72.6%	Male, 27.6% Female, 72.4%
Race ratio	Black or African American, 9.9% Unknown, 4.2% Hispanic or Latino, 16.4% Asian, 8.4% White, 59.9% American Indian and Alaska Native, 1.2%	Black or African American, 11.3% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage	9%	10%

Differences between reimbursement analyst and claims analyst duties and responsibilities

Reimbursement analyst example responsibilities.

Cultivate relationships with key contacts at insurance companies and manage care organizations, CMS and medical professional societies.
Contract interpretation and enforcement of the agreement with multiple medical insurance companies through written and oral appeals is accomplished daily.
Coordinate third party audits, defend preferential reporting practices and maintain current knowledge of Medicare and Medicaid reimbursement regulations.
Update Meditech charge master with correct pharmacy pricing and HCPCS codes.
Provide overall follow-up and coordination with Medicare and Medicare HMO plans and process with Medicare and Medicare HMO adjustments.
Train on and implement eClinicalworks for several physician practices, taking them live from paper to full electronic medical records.

Claims analyst example responsibilities.

Help managed meetings regarding decision making on CMS regulations.
Process UB's and HCFA's according to guidelines.
Analyze and investigate medical claims utilizing ICD-9 and CPT-4 coding.
Review claims (HCFA and UB) for accurate billing submission.
Interpret medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes for member submit claims.
Acquire biometrics and perform phlebotomy.

Reimbursement analyst vs claims analyst skills

Common reimbursement analyst skills

Patients, 11%
Medicare, 7%
Medicaid, 7%
Home Health, 5%
Appeals, 5%
Revenue Cycle, 4%

Common claims analyst skills

Customer Service, 14%
Medical Terminology, 5%
CPT, 5%
Process Claims, 5%
Medicaid, 5%
Data Entry, 5%

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Reimbursement Analyst vs Claims Analyst

Updated January 8, 2025

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