Insurance claims processor vs medical billing clerk

The differences between insurance claims processors and medical billing clerks can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become an insurance claims processor, becoming a medical billing clerk takes usually requires 1-2 years. Additionally, an insurance claims processor has an average salary of $37,151, which is higher than the $33,566 average annual salary of a medical billing clerk.

The top three skills for an insurance claims processor include data entry, customer service and medicaid. The most important skills for a medical billing clerk are patients, medical billing, and healthcare.

Insurance claims processor vs medical billing clerk overview

	Insurance Claims Processor	Medical Billing Clerk
Yearly salary	$37,151	$33,566
Hourly rate	$17.86	$16.14
Growth rate	-3%	-3%
Number of jobs	48,777	164,870
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 30%	Associate Degree, 30%
Average age	44	46
Years of experience	4	2

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 a medical billing clerk do?

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.

Insurance claims processor vs medical billing clerk salary

Insurance claims processors and medical billing clerks have different pay scales, as shown below.

	Insurance Claims Processor	Medical Billing Clerk
Average salary	$37,151	$33,566
Salary range	Between $30,000 And $45,000	Between $27,000 And $40,000
Highest paying City	Eden Prairie, MN	San Leandro, CA
Highest paying state	Connecticut	Washington
Best paying company	Accenture	iCare
Best paying industry	Insurance	Health Care

Differences between insurance claims processor and medical billing clerk education

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

	Insurance Claims Processor	Medical Billing Clerk
Most common degree	Bachelor's Degree, 30%	Associate Degree, 30%
Most common major	Business	Health Care Administration
Most common college	-	Stanford University

Insurance claims processor vs medical billing clerk demographics

Here are the differences between insurance claims processors' and medical billing clerks' demographics:

	Insurance Claims Processor	Medical Billing Clerk
Average age	44	46
Gender ratio	Male, 20.3% Female, 79.7%	Male, 11.3% Female, 88.7%
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, 10.4% Unknown, 4.3% Hispanic or Latino, 21.9% Asian, 6.8% White, 55.8% American Indian and Alaska Native, 0.8%
LGBT Percentage	11%	7%

Differences between insurance claims processor and medical billing clerk 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.

Medical billing clerk example responsibilities.

Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Interact with patients as part of the quality assurance process (follow-up, EHR confirmation, billing confirmation).
Reconcile insurance and patient payments while researching and resolving incorrect payments, EOB rejections, and assort issues with outstanding accounts.
Utilize medical terminology and follow HIPAA guidelines.
Bill Magellan through Nextgen system.
Double checked CMS-1500 form before posting it out to the insurance companies.

Insurance claims processor vs medical billing clerk skills

Common insurance claims processor skills

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

Common medical billing clerk skills

Patients, 18%
Medical Billing, 10%
Healthcare, 7%
Data Entry, 7%
Customer Service, 6%
Medicaid, 5%

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Insurance Claims Processor
Insurance Claims Processor vs Medical Billing Clerk

Updated January 8, 2025

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