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Senior claims examiner vs senior claims specialist

The differences between senior claims examiners and senior claims 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 examiner and a senior claims specialist. Additionally, a senior claims specialist has an average salary of $69,808, which is higher than the $50,962 average annual salary of a senior claims examiner.

The top three skills for a senior claims examiner include customer service, litigation and property damage. The most important skills for a senior claims specialist are customer service, litigation, and claims handling.

Senior claims examiner vs senior claims specialist overview

Senior Claims ExaminerSenior Claims Specialist
Yearly salary$50,962$69,808
Hourly rate$24.50$33.56
Growth rate-6%-6%
Number of jobs10,93111,011
Job satisfaction--
Most common degreeBachelor's Degree, 58%Bachelor's Degree, 65%
Average age4444
Years of experience66

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 senior claims specialist do?

A senior claims specialist's role is to handle and process insurance claims, ensuring accuracy and smooth workflow. Their responsibilities include liaising with clients to identify their needs, reviewing and validating documentation, resolving issues and concerns, and traveling to different locations in order to perform claims inspections and investigations for client eligibility. They may also approve claims applications and negotiate settlements. Furthermore, as a senior claims specialist, it is essential to lead and serve as a mentor to junior specialists, all while implementing the company's policies and regulations.

Senior claims examiner vs senior claims specialist salary

Senior claims examiners and senior claims specialists have different pay scales, as shown below.

Senior Claims ExaminerSenior Claims Specialist
Average salary$50,962$69,808
Salary rangeBetween $34,000 And $75,000Between $45,000 And $107,000
Highest paying CityUrban Honolulu, HI-
Highest paying stateHawaii-
Best paying companyW. R. Berkley-
Best paying industryFinance-

Differences between senior claims examiner and senior claims specialist education

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

Senior Claims ExaminerSenior Claims Specialist
Most common degreeBachelor's Degree, 58%Bachelor's Degree, 65%
Most common majorBusinessBusiness
Most common collegeStanford UniversityStanford University

Senior claims examiner vs senior claims specialist demographics

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

Senior Claims ExaminerSenior Claims Specialist
Average age4444
Gender ratioMale, 29.6% Female, 70.4%Male, 40.7% Female, 59.3%
Race ratioBlack 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, 12.0% Unknown, 4.4% Hispanic or Latino, 16.8% Asian, 5.2% White, 61.0% American Indian and Alaska Native, 0.5%
LGBT Percentage10%10%

Differences between senior claims examiner and senior claims specialist 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

Senior claims specialist example responsibilities.

  • Manage assigned third party administration (TPA) multi-jurisdictional workers' compensation; subrogation recovery claims; assign defense attorney.
  • Work toward settlement with claimants and attorneys, or determine company litigation strategy, participating in mediation and arbitration when necessary.
  • Maintain EDI processing table logic.
  • Work with testing HIPAA transactions, reporting and processing data reporting to the state.
  • Review data entry of claims receive through the EDI system for accuracy prior to processing.
  • Operate within all company regulations regarding HIPAA, fraud, confidentiality, and private health information guidelines.
  • Show more

Senior claims examiner vs senior claims specialist skills

Common senior claims examiner skills
  • Customer Service, 21%
  • Litigation, 11%
  • Property Damage, 9%
  • Claims Handling, 6%
  • TPA, 4%
  • Coverage Issues, 4%
Common senior claims specialist skills
  • Customer Service, 26%
  • Litigation, 10%
  • Claims Handling, 8%
  • SR, 5%
  • Settlement Conferences, 5%
  • Excellent Interpersonal, 4%

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