Senior claims specialist vs claims director

The differences between senior claims specialists and claims directors 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 specialist and a claims director. Additionally, a claims director has an average salary of $118,250, which is higher than the $69,808 average annual salary of a senior claims specialist.

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

Senior claims specialist vs claims director overview

	Senior Claims Specialist	Claims Director
Yearly salary	$69,808	$118,250
Hourly rate	$33.56	$56.85
Growth rate	-6%	-6%
Number of jobs	11,011	13,299
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 65%	Bachelor's Degree, 68%
Average age	44	44
Years of experience	6	6

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.

What does a claims director do?

A claims director spearheads and oversees the daily operations of an insurance company's claims department. They have the authority to make decisions and changes, set goals and timelines, establish guidelines and budgets, liaise with key external partners, coordinate managers and teams, delegate responsibilities, and conduct research and analysis to find opportunities that will optimize the department's operations. Moreover, a claims director leads and encourages staff to reach goals, all while implementing the company's claims policies and regulations, developing new ones as needed.

Senior claims specialist vs claims director salary

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

	Senior Claims Specialist	Claims Director
Average salary	$69,808	$118,250
Salary range	Between $45,000 And $107,000	Between $73,000 And $190,000
Highest paying City	-	-
Highest paying state	-	-
Best paying company	-	-
Best paying industry	-	-

Differences between senior claims specialist and claims director education

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

	Senior Claims Specialist	Claims Director
Most common degree	Bachelor's Degree, 65%	Bachelor's Degree, 68%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Senior claims specialist vs claims director demographics

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

	Senior Claims Specialist	Claims Director
Average age	44	44
Gender ratio	Male, 40.7% Female, 59.3%	Male, 58.2% Female, 41.8%
Race ratio	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%	Black or African American, 10.7% Unknown, 4.4% Hispanic or Latino, 17.0% Asian, 5.3% White, 62.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	10%	10%

Differences between senior claims specialist and claims director duties and responsibilities

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.

Claims director example responsibilities.

Create project team that comply with new Medicare reporting requirements achieving successful reporting to CMS.
Maintain relationships with attorneys and manage litigation strategy; ensure strong relationships with insureds, brokers and third party administrators.
Redesign processes and procedures for managing litigation through the implementation of an aggressive process for managing discovery and case typing.
General knowledge of CPT, ICD-9, HCPCS, DRG and Medicode (UCR), bundling and unbundling.
File and respond to online arbitration matters.
Facilitate annual updates to all new and revise CPT codes assuring accurate claims payment.

Senior claims specialist vs claims director skills

Common senior claims specialist skills

Customer Service, 26%
Litigation, 10%
Claims Handling, 8%
SR, 5%
Settlement Conferences, 5%
Excellent Interpersonal, 4%

Common claims director skills

Customer Service, 17%
Litigation, 11%
Oversight, 9%
Coverage Issues, 6%
Claims Handling, 5%
Claims Operations, 5%

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Senior Claims Specialist
Senior Claims Specialist vs Claims Director

Updated January 8, 2025

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