Senior claims examiner vs medical claims analyst

The differences between senior claims examiners and medical claims analysts 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 examiner and a medical claims analyst. Additionally, a senior claims examiner has an average salary of $50,962, which is higher than the $46,708 average annual salary of a medical claims analyst.

The top three skills for a senior claims examiner include customer service, litigation and property damage. The most important skills for a medical claims analyst are medical terminology, medicaid, and medical insurance claims.

Senior claims examiner vs medical claims analyst overview

	Senior Claims Examiner	Medical Claims Analyst
Yearly salary	$50,962	$46,708
Hourly rate	$24.50	$22.46
Growth rate	-6%	-6%
Number of jobs	10,931	65,897
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 36%
Average age	44	44
Years of experience	6	6

What does a senior claims examiner do?

Senior claims examiners review, assess, and process the insurance claims of their clients. The examiners provide recommendations for claims-related resolution. It is their responsibility to examine and authorize the investigation of insurance claims as conducted by insurance adjusters. They check the claims and the insurance policies to ensure that all the information is right. During the settlement, they are expected to be careful in keeping the records with details of the process.

What does a medical claims analyst do?

A medical claims analyst audits or verifies medical claims in insurance companies. Medical claims analysts make sure that corporate reimbursement payments are accurate. Usually, they work at an office on a computer workstation. They receive Medicaid claims from specialty and medical providers for reimbursement. Their job includes the development of an enhanced procedure in handling difficult Medicare/Medicaid letters while complying with the set policies.

Senior claims examiner vs medical claims analyst salary

Senior claims examiners and medical claims analysts have different pay scales, as shown below.

	Senior Claims Examiner	Medical Claims Analyst
Average salary	$50,962	$46,708
Salary range	Between $34,000 And $75,000	Between $32,000 And $68,000
Highest paying City	Urban Honolulu, HI	Bridgewater, NJ
Highest paying state	Hawaii	New Jersey
Best paying company	W. R. Berkley	Montefiore Mount Vernon Hospital
Best paying industry	Finance	Insurance

Differences between senior claims examiner and medical claims analyst education

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

	Senior Claims Examiner	Medical Claims Analyst
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 36%
Most common major	Business	Business
Most common college	Stanford University	University of Pennsylvania

Senior claims examiner vs medical claims analyst demographics

Here are the differences between senior claims examiners' and medical claims analysts' demographics:

	Senior Claims Examiner	Medical Claims Analyst
Average age	44	44
Gender ratio	Male, 29.6% Female, 70.4%	Male, 14.2% Female, 85.8%
Race ratio	Black or African American, 10.8% Unknown, 4.4% Hispanic or Latino, 16.8% Asian, 5.2% White, 62.3% American Indian and Alaska Native, 0.5%	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 16.4% Asian, 5.1% White, 62.4% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between senior claims examiner and medical claims analyst duties and responsibilities

Senior claims examiner example responsibilities.

Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
Coordinate vendor referrals for additional investigation and/or litigation management
Maintain office records of various types of complaints, conciliation, administrative decision, private litigation resolution, gather detailed information.
Ensure all HIPPA regulations are followed in the creation and release of all confidential records.
Coordinate vendor referrals for additional investigation and/or litigation management

Medical claims analyst example responsibilities.

Manage cases by aggressively directing the litigation process.
Analyze incoming medical claims using ICD-9, CPT, HCPCS coding, and Medicare fee schedules.
Determine if claims are in compliance under patient benefit plans for payments using DRG regulations :
Review medical records to determine if the ICD-9, CPT codes and modifiers are processed correctly.
Adhere to the HIPAA privacy, security regulations, and maintain confidentiality of patient a business records.
Research medical claims issues in response to informational inquiries by accessing and interpreting EOB's and claims history.

Senior claims examiner vs medical claims analyst skills

Common senior claims examiner skills

Customer Service, 21%
Litigation, 11%
Property Damage, 9%
Claims Handling, 6%
TPA, 4%
Coverage Issues, 4%

Common medical claims analyst skills

Medical Terminology, 9%
Medicaid, 6%
Medical Insurance Claims, 6%
Customer Service, 6%
Data Entry, 6%
Patients, 5%

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Senior Claims Examiner
Senior Claims Examiner vs Medical Claims Analyst

Updated January 8, 2025

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