Insurance claims processor vs insurance biller

The differences between insurance claims processors and insurance billers can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both an insurance claims processor and an insurance biller. Additionally, an insurance claims processor has an average salary of $37,151, which is higher than the $35,822 average annual salary of an insurance biller.

The top three skills for an insurance claims processor include data entry, customer service and medicaid. The most important skills for an insurance biller are patients, medical terminology, and CPT.

Insurance claims processor vs insurance biller overview

	Insurance Claims Processor	Insurance Biller
Yearly salary	$37,151	$35,822
Hourly rate	$17.86	$17.22
Growth rate	-3%	-3%
Number of jobs	48,777	84,361
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 30%	High School Diploma, 26%
Average age	44	44
Years of experience	4	4

What does an insurance claims processor do?

A claims processor usually works in health or property insurance claims. They are responsible for processing and evaluating the claim forms, monitoring and verifying information, and closely communicating with the company's clients, beneficiaries, and agents. Also, they handle queries and comments, calculate possible claims, and process of various payments. They also need to ensure all insurance company guidelines and policies are adhered to in order to avoid discrepancies, issues, and other problems regarding a client's claims.

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.

Insurance claims processor vs insurance biller salary

Insurance claims processors and insurance billers have different pay scales, as shown below.

	Insurance Claims Processor	Insurance Biller
Average salary	$37,151	$35,822
Salary range	Between $30,000 And $45,000	Between $28,000 And $44,000
Highest paying City	Eden Prairie, MN	-
Highest paying state	Connecticut	-
Best paying company	Accenture	-
Best paying industry	Insurance	-

Differences between insurance claims processor and insurance biller education

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

	Insurance Claims Processor	Insurance Biller
Most common degree	Bachelor's Degree, 30%	High School Diploma, 26%
Most common major	Business	Business
Most common college	-	-

Insurance claims processor vs insurance biller demographics

Here are the differences between insurance claims processors' and insurance billers' demographics:

	Insurance Claims Processor	Insurance Biller
Average age	44	44
Gender ratio	Male, 20.3% Female, 79.7%	Male, 6.9% Female, 93.1%
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, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	11%

Differences between insurance claims processor and insurance biller duties and responsibilities

Insurance claims processor example responsibilities.

Manage cases by aggressively directing the litigation process.
Maintain confidentiality in accordance with HIPAA laws.
Process ICD-9 codes, diagnostic and procedure codes.
Handle confidential information according to HIPPA and JAACHO standards.
Follow and comply with HIPPA rules and regulations to ensure patient privacy.
Process medical and dental claims using appropriate CPT, ICD-9, and ADA coding.

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 claims processor vs insurance biller skills

Common insurance claims processor skills

Data Entry, 18%
Customer Service, 11%
Medicaid, 8%
Medical Terminology, 6%
Insurance Coverage, 5%
ICD-9, 4%

Common insurance biller skills

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

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Insurance Claims Processor
Insurance Claims Processor vs Insurance Biller

Updated January 8, 2025

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