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Senior claims specialist vs claims manager

The differences between senior claims specialists and claims managers 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 manager. Additionally, a claims manager has an average salary of $73,369, 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 manager are customer service, oversight, and litigation.

Senior claims specialist vs claims manager overview

Senior Claims SpecialistClaims Manager
Yearly salary$69,808$73,369
Hourly rate$33.56$35.27
Growth rate-6%-6%
Number of jobs11,01130,302
Job satisfaction-5
Most common degreeBachelor's Degree, 65%Bachelor's Degree, 66%
Average age4447
Years of experience66

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 manager do?

A claims manager is an individual who works in an insurance-based firm and is responsible for managing the insurance claims department that is composed of examiners and adjusters. Claims managers are required to maintain claim files and reviewing these files as well as communicate with customers to follow up regarding issues they face with insurance claims. They must determine who is liable for the damage if there were other parties involved. Claims managers must also include an expert to assess the amount of damage and avoid insurance fraud.

Senior claims specialist vs claims manager salary

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

Senior Claims SpecialistClaims Manager
Average salary$69,808$73,369
Salary rangeBetween $45,000 And $107,000Between $45,000 And $117,000
Highest paying City-San Francisco, CA
Highest paying state-California
Best paying company-Zurich
Best paying industry-Insurance

Differences between senior claims specialist and claims manager education

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

Senior Claims SpecialistClaims Manager
Most common degreeBachelor's Degree, 65%Bachelor's Degree, 66%
Most common majorBusinessBusiness
Most common collegeStanford UniversityCalifornia State University - Bakersfield

Senior claims specialist vs claims manager demographics

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

Senior Claims SpecialistClaims Manager
Average age4447
Gender ratioMale, 40.7% Female, 59.3%Male, 47.9% Female, 52.1%
Race ratioBlack 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, 10.0% Unknown, 4.8% Hispanic or Latino, 17.1% Asian, 5.9% White, 61.5% American Indian and Alaska Native, 0.7%
LGBT Percentage10%8%

Differences between senior claims specialist and claims manager 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.
  • Show more

Claims manager example responsibilities.

  • Manage multiple outsource PPO networks that enable company to increase top line revenue.
  • Achieve improved structure and efficiency with initiation of pip specific unit.
  • Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
  • Oversee implementation and management of litigation and expense protocols including AFA agreements and BLO oversight.
  • Respond to all DOI questions and concerns.
  • Work with TPA, service providers and personnel on the design, implementation, and management of wellness programs.
  • Show more

Senior claims specialist vs claims manager skills

Common senior claims specialist skills
  • Customer Service, 26%
  • Litigation, 10%
  • Claims Handling, 8%
  • SR, 5%
  • Settlement Conferences, 5%
  • Excellent Interpersonal, 4%
Common claims manager skills
  • Customer Service, 15%
  • Oversight, 11%
  • Litigation, 8%
  • Direct Reports, 4%
  • Claims Handling, 4%
  • Insurance Claims, 3%

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