Key Differences Between Office Administrators and Claims Advocates

Office administrators and claims advocates are two critical, but different, roles for managing the insurance billing for restoration contractors. They have different responsibilities and require different skill sets. However, many restoration contractors mistakenly combine these roles into one. Let’s take a look at the differences and some similarities between these jobs, and why they’re both important for your business.

Roles of Office Administrators

Office administrators take on a large variety of jobs within the office. Theresa Crosland has been an office administrator for One Claim Solution (OCS) for about 3 years and says her key roles are making sure the office is running efficiently and all employees are equipped with the tools and resources to complete their job. This includes workstation setup, resolving technical issues, making sure bills are paid, handling new employee onboarding, and processing payroll.

“I also assist in the accounts receivable process of our company and communicate with our contractors regarding insurance payments they have received directly,” Theresa said.

According to Theresa, the skills that an effective office administrator should possess are organization, time management, attention to detail, clerical skills, multi-tasking, and the ability to build relationships. Having worked as a claims advocate previously, Theresa can provide valuable insights into the requirements of both roles.

“Similar to office administrators, claim advocates need to be detail oriented and have written and verbal communication skills,” Theresa said. “However, claim advocates will need extra training to understand the mitigation processes that contractors are billing for to complete accurate justifications for invoices. They will also need to learn good negotiating skills to get as much money for contractors as they can.”

Roles of Claims Advocates

In comparison to office administrators, the role of a claims advocate is more specialized. Claims advocates have one primary job which is to manage the claims that are submitted to insurance companies from submission to payment. This involves many different tasks such as scrutinizing the documentation for errors before it is submitted, following up with the insurance company, answering questions, resolving disputes, and negotiating. If you have a large number of jobs, hiring a claims advocate is important for streamlining your cash flow and functioning more effectively as a business.

Madalyn Morgan started working as an OCS Claims Advocate three and a half years ago and has since transitioned into the role of Claims Team Lead.

According to Madalyn, some of the qualities that OCS looks for when hiring claim advocates is someone with good customer service skills, the ability to learn and adapt, and a sense of urgency.

“We see invoices maybe two weeks to a month after the job has already been done. That means that the contractor has already paid their employees and they’ve bought the materials to do the job, so they’re in the negative right now in their bank account,” Madalyn said. “So there’s that sense of urgency that you have to get it done and do it in a professional and polite manner as well.”

Madalyn joined the OCS team without any prior knowledge or experience as a claims advocate. However, she attests that the comprehensive training process at OCS was pivotal in equipping her to excel in her role as an effective claims advocate. The training program for claim advocates employs a practical, hands-on approach, providing ongoing guidance and support to ensure their professional development and success.

During the initial weeks of training, Madalyn attended classroom sessions with presentations and tests, followed by observing and being observed by experienced colleagues at work.

“This hands-on approach allowed me to learn by watching their interactions, call responses, and work methods,” Madalyn said. “Even after I had my own desk, computer, and claims to handle, the learning continued with ongoing training, weekly check-ins, and performance reviews. It’s a dynamic industry where we constantly adapt to OSHA standards, regulations, laws, and market changes.”

A Final Word

Recognizing the distinctions between office administrators and claims advocates is crucial for restoration contractors seeking to effectively manage insurance billing. By gaining a thorough understanding of the distinct responsibilities and required skill sets for each role, contractors can make informed decisions when hiring personnel to effectively support their office operations. For more information on how our claim advocates can support your restoration business, be sure to subscribe to our newsletter.