Billing coder vs billing specialist

The differences between billing coders and billing specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 1-2 years to become both a billing coder and a billing specialist. Additionally, a billing coder has an average salary of $37,554, which is higher than the $35,624 average annual salary of a billing specialist.

The top three skills for a billing coder include patients, ICD-10 and data entry. The most important skills for a billing specialist are patients, customer service, and data entry.

Billing coder vs billing specialist overview

	Billing Coder	Billing Specialist
Yearly salary	$37,554	$35,624
Hourly rate	$18.05	$17.13
Growth rate	-3%	-3%
Number of jobs	55,376	55,205
Job satisfaction	-	-
Most common degree	Associate Degree, 32%	Bachelor's Degree, 31%
Average age	46	46
Years of experience	2	2

What does a billing coder do?

A billing coder usually works at medical facilities where they are primarily in charge of gathering and analyzing patient information and billing data, translating them according to the special coding system for medical and insurance record purposes. They usually work in an office setting where they manage electronic health records, organize files, handle calls and correspondence, coordinate with different departments, and enter insurance claims into particular programs. Moreover, as a billing coder, it is essential to review records, keeping an eye out for any inconsistencies or missing details, performing corrective measures right away.

What does a billing specialist do?

Billing specialists are accounting or finance employees who are responsible for sending out billing invoices to clients. They calculate charges that their clients have incurred. They then write bills, ensure that all details are correct, and send these out to clients. They also manage payment due dates and ensure that clients are duly reminded of such deadlines. Billing specialists also manage client accounts and ensure that they are paying on time. They help identify clients who have outstanding payables and send out collection notices to them. At times, billing specialists also manage the receipt of payments to manage account records better.

Billing coder vs billing specialist salary

Billing coders and billing specialists have different pay scales, as shown below.

	Billing Coder	Billing Specialist
Average salary	$37,554	$35,624
Salary range	Between $30,000 And $45,000	Between $27,000 And $45,000
Highest paying City	-	Washington, DC
Highest paying state	-	Delaware
Best paying company	-	TIBCO Software
Best paying industry	-	Manufacturing

Differences between billing coder and billing specialist education

There are a few differences between a billing coder and a billing specialist in terms of educational background:

	Billing Coder	Billing Specialist
Most common degree	Associate Degree, 32%	Bachelor's Degree, 31%
Most common major	Health Care Administration	Business
Most common college	Stanford University	University of Pennsylvania

Billing coder vs billing specialist demographics

Here are the differences between billing coders' and billing specialists' demographics:

	Billing Coder	Billing Specialist
Average age	46	46
Gender ratio	Male, 8.8% Female, 91.2%	Male, 12.7% Female, 87.3%
Race ratio	Black or African American, 11.1% Unknown, 4.3% Hispanic or Latino, 20.9% Asian, 6.8% White, 56.1% American Indian and Alaska Native, 0.8%	Black or African American, 10.9% Unknown, 4.4% Hispanic or Latino, 19.2% Asian, 7.4% White, 57.3% American Indian and Alaska Native, 0.9%
LGBT Percentage	7%	7%

Differences between billing coder and billing specialist duties and responsibilities

Billing coder example responsibilities.

Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Review documentation to assign or confirm E/M, CPT, HCPCS, modifiers and ICD-9 codes.
Process insurance claims to various carriers like Medicare, Medicaid, commercial, and private insurances.
Verify patient insurance and/or Medicaid eligibility status and produce 'no insurance' letters for non establish patients.
Use EMR to submit claims.
Correct coding of CPT, HCPCS and ICD-9 codes necessary to ensure appropriate reimbursement.

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Billing specialist example responsibilities.

Use of QuickBooks to manage vendors' accounts, set up filing system to maintain files and supporting billing documents.
Manage the daily correspondence with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
Use independent judgment, manage and impart confidential information appropriately per HIPAA regulations and company requirements.
Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Provide additional information/clarification for insurance claims using knowledge of CPT, ICD-9, and HCPCS codes, as well as modifiers.
Assist staff with proper billing for patients, ensure proper coding using ICD-10, ICD-9 and CPT-4 coding.

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Billing coder vs billing specialist skills

Common billing coder skills

Patients, 18%
ICD-10, 9%
Data Entry, 7%
Medical Terminology, 5%
Home Health, 5%
HCPCS, 5%

Common billing specialist skills

Patients, 16%
Customer Service, 10%
Data Entry, 9%
Medical Billing, 7%
Medicaid, 6%
CPT, 3%

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Updated January 8, 2025

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