Insurance biller vs insurance verification specialist

The differences between insurance billers and insurance verification specialists can be seen in a few details. Each job has different responsibilities and duties. Additionally, an insurance biller has an average salary of $35,822, which is higher than the $33,043 average annual salary of an insurance verification specialist.

The top three skills for an insurance biller include patients, medical terminology and CPT. The most important skills for an insurance verification specialist are patients, insurance verification, and customer service.

Insurance biller vs insurance verification specialist overview

	Insurance Biller	Insurance Verification Specialist
Yearly salary	$35,822	$33,043
Hourly rate	$17.22	$15.89
Growth rate	-3%	6%
Number of jobs	84,361	71,688
Job satisfaction	-	-
Most common degree	High School Diploma, 26%	Associate Degree, 27%
Average age	44	46
Years of experience	4	-

What does an insurance biller do?

An insurance biller is responsible for making daily reviews and processing documents concerning the insurance payment and bills of a client. They assess if all requirements are correct and complete, obtain different referrals and authorization papers, and prepare and transmit document claims using a particular software. Also, they do follow ups regarding unpaid claims and update spreadsheets for record purposes.

What does an insurance verification specialist do?

An insurance verification specialist is responsible for confirming a patient's insurance details and eligibility to receive medical care services. Insurance verification specialists review the insurance documents of the patients, including its coverage and limitations, and escalate concerns to the supervisor for immediate resolution. They process paperwork accordingly upon coordinating with the patients and attending health professionals. An insurance verification specialist must have excellent communication and organizational skills, finishing administrative tasks efficiently under minimal supervision.

Insurance biller vs insurance verification specialist salary

Insurance billers and insurance verification specialists have different pay scales, as shown below.

	Insurance Biller	Insurance Verification Specialist
Average salary	$35,822	$33,043
Salary range	Between $28,000 And $44,000	Between $28,000 And $37,000
Highest paying City	-	Madison, WI
Highest paying state	-	New Hampshire
Best paying company	-	St. Luke's Cataract & Laser Institute
Best paying industry	-	Pharmaceutical

Differences between insurance biller and insurance verification specialist education

There are a few differences between an insurance biller and an insurance verification specialist in terms of educational background:

	Insurance Biller	Insurance Verification Specialist
Most common degree	High School Diploma, 26%	Associate Degree, 27%
Most common major	Business	Health Care Administration
Most common college	-	University of Pennsylvania

Insurance biller vs insurance verification specialist demographics

Here are the differences between insurance billers' and insurance verification specialists' demographics:

	Insurance Biller	Insurance Verification Specialist
Average age	44	46
Gender ratio	Male, 6.9% Female, 93.1%	Male, 11.4% Female, 88.6%
Race ratio	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%	Black or African American, 9.3% Unknown, 3.6% Hispanic or Latino, 16.0% Asian, 4.9% White, 66.1% American Indian and Alaska Native, 0.1%
LGBT Percentage	11%	7%

Differences between insurance biller and insurance verification specialist duties and responsibilities

Insurance biller example responsibilities.

Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
Utilize ICD-9 and CPT codes, enter charges, and send statements for billing purposes.
Process monetary transactions, insurance payments and enter into bookkeeping ledgers and monthly statements to patients.
Submit medical claims for reimbursement on medical services provide to patients by medical provider for reimbursement.
Code and post hospital and office charges using ICD-9, CPT-4.
Look up ICD-9 codes to verify if a code has been change and enter.

Insurance verification specialist example responsibilities.

Check CPT and ICD-10 codes with LCD and policies from multiple insurance companies to make sure procedures will be paid.
Support the patient privacy/confidentiality policies and regulations under HIPAA for patients and their medical records.
Confirm correct charges base on HCPCS codes.
Assist callers as well with questions about their benefits, terms and conditions of medical plans, appeals and grievances.
Provide medical record support in the absence of EMR: assist clinics and hospitals in obtaining medical records in appropriate format.
Document outbound communication from providers and veterans.

Insurance biller vs insurance verification specialist skills

Common insurance biller skills

Patients, 15%
Medical Terminology, 10%
CPT, 8%
Medi-Cal, 6%
Data Entry, 5%
Insurance Claims, 5%

Common insurance verification specialist skills

Patients, 25%
Insurance Verification, 15%
Customer Service, 7%
Insurance Eligibility, 5%
Data Entry, 4%
Medical Terminology, 4%

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Insurance Biller
Insurance Biller vs Insurance Verification Specialist

Updated January 8, 2025

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