Reimbursement analyst vs reimbursement specialist

The differences between reimbursement analysts and reimbursement 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 reimbursement analyst and a reimbursement specialist. Additionally, a reimbursement analyst has an average salary of $65,489, which is higher than the $38,273 average annual salary of a reimbursement specialist.

The top three skills for a reimbursement analyst include patients, medicare and medicaid. The most important skills for a reimbursement specialist are patients, customer service, and appeals.

Reimbursement analyst vs reimbursement specialist overview

	Reimbursement Analyst	Reimbursement Specialist
Yearly salary	$65,489	$38,273
Hourly rate	$31.49	$18.40
Growth rate	11%	11%
Number of jobs	10,216	32,292
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 40%
Average age	45	45
Years of experience	12	12

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 reimbursement specialist do?

A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.

Reimbursement analyst vs reimbursement specialist salary

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

	Reimbursement Analyst	Reimbursement Specialist
Average salary	$65,489	$38,273
Salary range	Between $48,000 And $87,000	Between $29,000 And $49,000
Highest paying City	Quincy, MA	Lynchburg, VA
Highest paying state	Massachusetts	Virginia
Best paying company	Tufts Health Plan	Novartis
Best paying industry	Pharmaceutical	Pharmaceutical

Differences between reimbursement analyst and reimbursement specialist education

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

	Reimbursement Analyst	Reimbursement Specialist
Most common degree	Bachelor's Degree, 62%	Bachelor's Degree, 40%
Most common major	Business	Business
Most common college	University of Pennsylvania	University of Pennsylvania

Reimbursement analyst vs reimbursement specialist demographics

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

	Reimbursement Analyst	Reimbursement Specialist
Average age	45	45
Gender ratio	Male, 27.4% Female, 72.6%	Male, 15.2% Female, 84.8%
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, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3%
LGBT Percentage	9%	9%

Differences between reimbursement analyst and reimbursement specialist 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.

Reimbursement specialist example responsibilities.

Manage the EDI clearinghouse rejections.
Process department payroll, order supplies, and manage petty-cash funds.
Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
Manage cases by aggressively directing the litigation process.
Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.

Reimbursement analyst vs reimbursement specialist skills

Common reimbursement analyst skills

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

Common reimbursement specialist skills

Patients, 20%
Customer Service, 9%
Appeals, 6%
CPT, 5%
Medicare, 4%
Medicaid, 4%

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Reimbursement Analyst
Reimbursement Analyst vs Reimbursement Specialist

Updated January 8, 2025

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