Senior claims processor vs senior claims representative

The differences between senior claims processors and senior claims representatives can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a senior claims processor, becoming a senior claims representative takes usually requires 4-6 years. Additionally, a senior claims representative has an average salary of $54,592, which is higher than the $44,873 average annual salary of a senior claims processor.

The top three skills for a senior claims processor include customer service, process claims and SR. The most important skills for a senior claims representative are customer service, claims handling, and litigation.

Senior claims processor vs senior claims representative overview

	Senior Claims Processor	Senior Claims Representative
Yearly salary	$44,873	$54,592
Hourly rate	$21.57	$26.25
Growth rate	-3%	-6%
Number of jobs	14,768	10,995
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 37%	Bachelor's Degree, 75%
Average age	44	44
Years of experience	4	6

Senior claims processor vs senior claims representative salary

Senior claims processors and senior claims representatives have different pay scales, as shown below.

	Senior Claims Processor	Senior Claims Representative
Average salary	$44,873	$54,592
Salary range	Between $30,000 And $65,000	Between $31,000 And $94,000
Highest paying City	-	-
Highest paying state	-	-
Best paying company	-	-
Best paying industry	-	-

Differences between senior claims processor and senior claims representative education

There are a few differences between a senior claims processor and a senior claims representative in terms of educational background:

	Senior Claims Processor	Senior Claims Representative
Most common degree	Bachelor's Degree, 37%	Bachelor's Degree, 75%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Senior claims processor vs senior claims representative demographics

Here are the differences between senior claims processors' and senior claims representatives' demographics:

	Senior Claims Processor	Senior Claims Representative
Average age	44	44
Gender ratio	Male, 16.3% Female, 83.7%	Male, 47.3% Female, 52.7%
Race ratio	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%	Black or African American, 11.2% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 5.1% White, 62.3% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	10%

Differences between senior claims processor and senior claims representative duties and responsibilities

Senior claims processor example responsibilities.

Manage confidential medical records and directs them to the appropriate practitioners while ensuring HIPPA regulations are maintain.
Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
Process CalPERS HMO facility claims.
Experience with HMO's, IPA's and insurance authorizations.
Handle confidential information according to new laws (HIPPA).
Review ICD-9 diagnosis codes against CPT codes for claim payment guidelines.

Senior claims representative example responsibilities.

Conduct detailed interviews with physicians, prepare comprehensive written reports, retain defense counsel, and effectively manage the litigation process.
Utilize Xactimate estimating system during field inspection to properly evaluate commercial property damages.
Update computer generate claim file (s) with medical diagnoses, current CPT and ICD codes.
Analyze claims using IDC and CPT coding and negotiate settlements with attorneys, claimants, medical providers, and insureds.
Set up independent medical examinations, issue denials, attend arbitration hearings.
Coordinate and attend various mediation and arbitration hearings as well as numerous settlement hearings and conferences.

Senior claims processor vs senior claims representative skills

Common senior claims processor skills

Customer Service, 16%
Process Claims, 8%
SR, 6%
Medical Terminology, 5%
Appeals, 5%
CMS, 5%

Common senior claims representative skills

Customer Service, 26%
Claims Handling, 14%
Litigation, 9%
Insurance Claims, 3%
Bodily Injury Claims, 3%
Automobile Claims, 3%

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Senior Claims Processor
Senior Claims Processor vs Senior Claims Representative

Updated January 8, 2025

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