Certification specialist vs reimbursement specialist

The differences between certification specialists and reimbursement specialists can be seen in a few details. Each job has different responsibilities and duties. Additionally, a certification specialist has an average salary of $45,265, which is higher than the $38,273 average annual salary of a reimbursement specialist.

The top three skills for a certification specialist include patients, medical terminology and surgical procedures. The most important skills for a reimbursement specialist are patients, customer service, and appeals.

Certification specialist vs reimbursement specialist overview

	Certification Specialist	Reimbursement Specialist
Yearly salary	$45,265	$38,273
Hourly rate	$21.76	$18.40
Growth rate	11%	11%
Number of jobs	43,565	32,292
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 40%
Average age	44	45
Years of experience	-	12

What does a certification specialist do?

A certification specialist is primarily in charge of conducting inspections and assessments, ensuring operations and procedures comply with certification guidelines and requirements. Although their responsibilities may vary upon their industry or organization of employment, it usually entails reviewing certification applications and system plans, arranging schedules and tests, organizing orientations, providing advice or guidance to new members of the workforce, and implementing strategies. Moreover, they also perform administrative support tasks such as processing the necessary documents, facilitating activities, and coordinating with internal and external parties.

What does a reimbursement specialist do?

A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.

Certification specialist vs reimbursement specialist salary

Certification specialists and reimbursement specialists have different pay scales, as shown below.

	Certification Specialist	Reimbursement Specialist
Average salary	$45,265	$38,273
Salary range	Between $25,000 And $81,000	Between $29,000 And $49,000
Highest paying City	New York, NY	Lynchburg, VA
Highest paying state	New York	Virginia
Best paying company	Apple	Novartis
Best paying industry	Insurance	Pharmaceutical

Differences between certification specialist and reimbursement specialist education

There are a few differences between a certification specialist and a reimbursement specialist in terms of educational background:

	Certification Specialist	Reimbursement Specialist
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 40%
Most common major	Business	Business
Most common college	Western Carolina University	University of Pennsylvania

Certification specialist vs reimbursement specialist demographics

Here are the differences between certification specialists' and reimbursement specialists' demographics:

	Certification Specialist	Reimbursement Specialist
Average age	44	45
Gender ratio	Male, 26.3% Female, 73.7%	Male, 15.2% Female, 84.8%
Race ratio	Black or African American, 6.4% Unknown, 4.6% Hispanic or Latino, 9.4% Asian, 8.8% White, 70.4% American Indian and Alaska Native, 0.4%	Black or African American, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3%
LGBT Percentage	11%	9%

Differences between certification specialist and reimbursement specialist duties and responsibilities

Certification specialist example responsibilities.

Support ISO audits for process documentation and software/ literature distribution, managing follow-up corrective action plans as needed.
Pre-Certify and scheduling of MRI's and bone scans.
Order supplies, apply cast, splints and other orthopedic equipment.
Prepare, apply, remove and adjusts casts and splints as advised by physician.
Review medical records to determine ICD-9 diagnosis and procedure codes according to establish guidelines and submit claims for processing.
Assign ICD-9 codes for various clinic types such as physical, occupational and speech therapies, diagnostics and labs.

Reimbursement specialist example responsibilities.

Manage the EDI clearinghouse rejections.
Process department payroll, order supplies, and manage petty-cash funds.
Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
Manage cases by aggressively directing the litigation process.
Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.

Certification specialist vs reimbursement specialist skills

Common certification specialist skills

Patients, 22%
Medical Terminology, 8%
Surgical Procedures, 6%
Medicaid, 5%
Data Entry, 4%
Certification Process, 4%

Common reimbursement specialist skills

Patients, 20%
Customer Service, 9%
Appeals, 6%
CPT, 5%
Medicare, 4%
Medicaid, 4%

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Certification Specialist
Certification Specialist vs Reimbursement Specialist

Updated January 8, 2025

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