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 specialist responsibilities
Here are examples of responsibilities from real billing specialist resumes:
- 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.
- Abstract pertinent information from patient reports and charts and assign appropriate ICD-9, CPT or HCPCS codes as required.
- Assign appropriate ICD-9, CPT and HCPCS code (s) to accurately support the need and documentation for each service.
- Ensure accuracy of procedures and diagnostic codes using ICD-9 and CPT-4 coding.
- Analyze patient records to verify benefits and apply appropriate codes (ICD-9 and CPT-4).
- Correct claim ICD-9 & ICD-10 coding issues and submit claim to insurance for reprocessing, extensive work with Medicare/Medicaid.
- Maintain current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Investigate reason for non-payment, set-up appeals process and provide necessary information and documentation to insurance carriers.
- Maintain up-to-date knowledge and understanding of procedures relate to Medicare, Medicaid and third-party insurance billing and reimbursement.
- Review insurance explanation of benefits and verify medical ICD-9 and CPT coding for accuracy to ensure proper allocation of benefits.
Billing specialist skills and personality traits
We calculated that 16% of Billing Specialists are proficient in Patients, Customer Service, and Data Entry. They’re also known for soft skills such as Communication skills, Math skills, and Organizational skills.
We break down the percentage of Billing Specialists that have these skills listed on their resume here:
- Patients, 16%
Verified insurance information, requested prior authorization for patients from doctors or insurance to establish coverage and medical necessity.
- Customer Service, 10%
Provided excellent customer service ensuring expectations have been met in reference to billing, existing services or potential service enhancements.
- Data Entry, 9%
Answered telephone inquiries in a timely and courteous manner Utilized data entry skills to maintain customer orders and assured proper processing
- Medical Billing, 7%
Recruited into position to assist 6 billing professionals in administrative support functions in a busy, medical billing/insurance preparation office.
- Medicaid, 6%
Maintain up-to-date knowledge and understanding of procedures related to Medicare, Medicaid and third-party insurance billing and reimbursement.
- CPT, 3%
Reviewed insurance explanation of benefits and verified medical ICD-9 and CPT coding for accuracy to ensure proper allocation of benefits.
Common skills that a billing specialist uses to do their job include "patients," "customer service," and "data entry." You can find details on the most important billing specialist responsibilities below.
Communication skills. The most essential soft skill for a billing specialist to carry out their responsibilities is communication skills. This skill is important for the role because "financial clerks should be able to explain policies and procedures to colleagues and customers." Additionally, a billing specialist resume shows how their duties depend on communication skills: "managed patient and therapist scheduling, billing, insurance claims, and office communications for a high volume physical therapy business. "
Math skills. Another soft skill that's essential for fulfilling billing specialist duties is math skills. The role rewards competence in this skill because "the job duties of financial clerks includes calculating charges and updating financial records." According to a billing specialist resume, here's how billing specialists can utilize math skills in their job responsibilities: "position required mathematical skills, accurate data entry, and ability to work efficiently on a deadline. "
Organizational skills. This is an important skill for billing specialists to perform their duties. For an example of how billing specialist responsibilities depend on this skill, consider that "financial clerks must be able to arrange files so they can find them quickly and efficiently." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of a billing specialist: "maintain a high degree of precision in data entry by paying strict attention to detail and the application of organizational skills. ".
The three companies that hire the most billing specialists are:
- Robert Half161 billing specialists jobs
- Expeditors101 billing specialists jobs
- Change Healthcare83 billing specialists jobs
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Compare different billing specialists
Billing specialist vs. Biller
Billers are medical professionals who are responsible for translating health care services into medical claims to be submitted to insurance companies. These billers are required to obtain patient medical records and interpret them to determine the billable units and services. They must manage all aspects of the medical billing process and make necessary contacts with insurance payers or patients to ensure maximum reimbursements. Billers must also provide services that are associated with internal and external customer billing and payment processing operations.
These skill sets are where the common ground ends though. The responsibilities of a billing specialist are more likely to require skills like "medical terminology," "billing statements," "payment arrangements," and "billing inquiries." On the other hand, a job as a biller requires skills like "math," "home health," "dmv," and "medi-cal." As you can see, what employees do in each career varies considerably.
Billers really shine in the manufacturing industry with an average salary of $42,377. Comparatively, billing specialists tend to make the most money in the manufacturing industry with an average salary of $37,417.The education levels that billers earn slightly differ from billing specialists. In particular, billers are 0.3% less likely to graduate with a Master's Degree than a billing specialist. Additionally, they're 0.1% less likely to earn a Doctoral Degree.Billing specialist vs. Medical billing clerk
A medical billing clerk is primarily in charge of processing payments and creating billing arrangements in clinics and hospitals. Among their responsibilities include gathering and verifying patient identification, handling insurance information, coding, updating databases, and maintaining records. It is also their responsibility to assist patients by filling out forms, answering their inquiries, and referring them to other services. Moreover, a medical billing clerk must monitor patient accounts and follow-up on delinquent patient accounts, coordinating with collection agencies as needed.
Each career also uses different skills, according to real billing specialist resumes. While billing specialist responsibilities can utilize skills like "cpt," "billing statements," "billing process," and "accounts receivables," medical billing clerks use skills like "healthcare," "cpt-4," "patient appointments," and "patient insurance."
Medical billing clerks earn a lower average salary than billing specialists. But medical billing clerks earn the highest pay in the health care industry, with an average salary of $34,137. Additionally, billing specialists earn the highest salaries in the manufacturing with average pay of $37,417 annually.medical billing clerks earn similar levels of education than billing specialists in general. They're 0.8% less likely to graduate with a Master's Degree and 0.1% more likely to earn a Doctoral Degree.Billing specialist vs. Billing and insurance coordinator
A billing and insurance coordinator is responsible for coordinating with employees from different departments of an organization for billing and insurance processing purposes. Billing and insurance coordinators sort mail for distribution to appropriate personnel, performing administrative and clerical duties as needed, managing and releasing of invoices under the manager's supervision, and responding to employees' inquiries and concerns. A billing and insurance coordinator must be highly analytical, as well as have excellent knowledge of the insurance disciplines and processes to assist the employees with their payments and benefits.
Some important key differences between the two careers include a few of the skills necessary to fulfill the responsibilities of each. Some examples from billing specialist resumes include skills like "submit claims," "medical terminology," "billing statements," and "clean claims," whereas a billing and insurance coordinator is more likely to list skills in "work ethic," "strong work ethic," "financial reports," and "elite. "
Billing and insurance coordinators earn the highest salary when working in the professional industry, where they receive an average salary of $58,069. Comparatively, billing specialists have the highest earning potential in the manufacturing industry, with an average salary of $37,417.billing and insurance coordinators typically earn similar educational levels compared to billing specialists. Specifically, they're 1.4% more likely to graduate with a Master's Degree, and 0.2% more likely to earn a Doctoral Degree.Billing specialist vs. Accounts receivable specialist
Accounts receivable specialists are members of the organization's finance or accounting department. They are responsible for managing the collection of payments for the company. They prepare official receipts and coordinate with account payable specialists from other companies with pending payables. They ensure that clients pay on time, and they also follow up on payments when necessary. They are responsible for checking whether the clients have already paid in full. Accounts receivable specialists are in charge of updating accounting records as well to ensure that client records are up to date.
Types of billing specialist
Updated January 8, 2025
