Senior claims analyst vs claims benefit specialist

The differences between senior claims analysts and claims benefit specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a senior claims analyst and a claims benefit specialist. Additionally, a senior claims analyst has an average salary of $79,886, which is higher than the $47,292 average annual salary of a claims benefit specialist.

The top three skills for a senior claims analyst include customer service, litigation and medical terminology. The most important skills for a claims benefit specialist are customer inquiries, appeals, and medical terminology.

Senior claims analyst vs claims benefit specialist overview

	Senior Claims Analyst	Claims Benefit Specialist
Yearly salary	$79,886	$47,292
Hourly rate	$38.41	$22.74
Growth rate	-6%	-6%
Number of jobs	21,159	32,208
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 61%	Bachelor's Degree, 40%
Average age	44	44
Years of experience	6	6

What does a senior claims analyst do?

Senior Claims Analysts are responsible for providing support and oversight on the process of liability claims. Their duties include verifying submitted claims, assessing reimbursement policies, performing reconciliation with claims estimates, and conducting payment negotiations. They manage claims processing costs, prepare payment documents, reclassify entries, and attend to requestors' queries. Senior Claims Analyst also organizes records and assist in providing mentorship and training sessions to junior staff.

What does a claims benefit specialist do?

Claims and benefits specialists ensure their company's compliance with the internal and external health plan partner processes. The job requires them to be sharp, organized, and able to multitask. They recommend strategies that will improve the processes present in the current trends that they constantly evaluate. These specialists manage portfolios of claims and benefits issues and ensure that they provide the best resolutions that follow the health plan processing guidelines to impress their clients.

Senior claims analyst vs claims benefit specialist salary

Senior claims analysts and claims benefit specialists have different pay scales, as shown below.

	Senior Claims Analyst	Claims Benefit Specialist
Average salary	$79,886	$47,292
Salary range	Between $52,000 And $122,000	Between $32,000 And $68,000
Highest paying City	San Leandro, CA	-
Highest paying state	Hawaii	-
Best paying company	Alameda Health System	-
Best paying industry	Finance	-

Differences between senior claims analyst and claims benefit specialist education

There are a few differences between a senior claims analyst and a claims benefit specialist in terms of educational background:

	Senior Claims Analyst	Claims Benefit Specialist
Most common degree	Bachelor's Degree, 61%	Bachelor's Degree, 40%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Senior claims analyst vs claims benefit specialist demographics

Here are the differences between senior claims analysts' and claims benefit specialists' demographics:

	Senior Claims Analyst	Claims Benefit Specialist
Average age	44	44
Gender ratio	Male, 30.8% Female, 69.2%	Male, 19.6% Female, 80.4%
Race ratio	Black or African American, 11.3% Unknown, 4.4% Hispanic or Latino, 16.7% Asian, 5.2% White, 62.0% American Indian and Alaska Native, 0.5%	Black or African American, 11.4% Unknown, 4.4% Hispanic or Latino, 16.9% Asian, 5.2% White, 61.6% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between senior claims analyst and claims benefit specialist duties and responsibilities

Senior claims analyst example responsibilities.

Accomplish facets and Macess user including running reports.
Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
Coordinate the maintenance of TPA payment type / code table conversions data.
Process claims, generate checks, create reports and correspond with TPA clients.
Review claims for correct billing information such as correct CPT codes, ICD code and patient information.
Analyze, evaluate, and conduct statistical data reviews as required by CMS in accordance with ZPIC policies.

Claims benefit specialist example responsibilities.

Analyze, process and manage FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
Establish a working knowledge of CPT, ICD-9, HCPCS codes, terminology, member benefits and claim flow.
Process claims utilizing appropriate ICD-9, DSM-IV and HCPCS codes.
Analyze each claim and calculate percentages for both PPO and NON-PPO providers.
Understand CPT, HCPCS, ICD-9-CM and ICD-10-CM medical claims coding regulations and guidelines
Process Non-HMO and PPO paper and electronic claims in an accurate and time manner.

Senior claims analyst vs claims benefit specialist skills

Common senior claims analyst skills

Customer Service, 7%
Litigation, 7%
Medical Terminology, 6%
Coverage Issues, 6%
Policy Provisions, 5%
Medicaid, 5%

Common claims benefit specialist skills

Customer Inquiries, 11%
Appeals, 7%
Medical Terminology, 6%
Routine Claims, 5%
CPT, 4%
Processing Issues, 4%

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Senior Claims Analyst
Senior Claims Analyst vs Claims Benefit Specialist

Updated January 8, 2025

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