Insurance verification representative vs billing representative

The differences between insurance verification representatives and billing representatives 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 verification representative, becoming a billing representative takes usually requires 1-2 years. Additionally, a billing representative has an average salary of $35,002, which is higher than the $32,706 average annual salary of an insurance verification representative.

The top three skills for an insurance verification representative include patients, insurance verification and customer service. The most important skills for a billing representative are patients, customer service, and data entry.

Insurance verification representative vs billing representative overview

	Insurance Verification Representative	Billing Representative
Yearly salary	$32,706	$35,002
Hourly rate	$15.72	$16.83
Growth rate	-4%	-3%
Number of jobs	150,260	95,425
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 28%	Bachelor's Degree, 30%
Average age	40	46
Years of experience	4	2

What does an insurance verification representative do?

An insurance verification representative is responsible for ensuring the coverage of a patient's healthcare benefits by required procedures. Your duties will typically include updating patient information, verifying insurance coverage of patients, and arranging payment for medical services that are not covered under insurance. In addition, you will be checking eligibility and benefits for healthcare providers and explaining Medicare and CMS guidelines as needed. As an insurance verification representative, you are also expected to advise and discuss various financing options that best fit a patient's budget.

What does a billing representative do?

A billing representative assists with the overall operations of the organization's billing department. Billing representatives post payments timely on the database, update account statements, generate financial reports, release invoices, and resolve account discrepancies. They also perform client accounts reconciliation as needed, monitor account receivables, review overdated balance, and notify clients of payment updates to ensure accurate and timely billing. A billing representative must have strong analytical and communication skills to manage clients' accounts, as well as comprehensive knowledge on the accounting industry to explain the payment terms and policies of an organization to a client.

Insurance verification representative vs billing representative salary

Insurance verification representatives and billing representatives have different pay scales, as shown below.

	Insurance Verification Representative	Billing Representative
Average salary	$32,706	$35,002
Salary range	Between $28,000 And $37,000	Between $28,000 And $42,000
Highest paying City	Charleston, WV	Worcester, MA
Highest paying state	Massachusetts	Massachusetts
Best paying company	Student Conservation Association	Relevante
Best paying industry	Health Care	Technology

Differences between insurance verification representative and billing representative education

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

	Insurance Verification Representative	Billing Representative
Most common degree	Bachelor's Degree, 28%	Bachelor's Degree, 30%
Most common major	Business	Business
Most common college	Stanford University	Stanford University

Insurance verification representative vs billing representative demographics

Here are the differences between insurance verification representatives' and billing representatives' demographics:

	Insurance Verification Representative	Billing Representative
Average age	40	46
Gender ratio	Male, 15.1% Female, 84.9%	Male, 15.7% Female, 84.3%
Race ratio	Black or African American, 12.6% Unknown, 4.8% Hispanic or Latino, 22.0% Asian, 6.3% White, 53.8% American Indian and Alaska Native, 0.6%	Black or African American, 10.4% Unknown, 4.3% Hispanic or Latino, 19.9% Asian, 7.3% White, 57.2% American Indian and Alaska Native, 0.9%
LGBT Percentage	7%	7%

Differences between insurance verification representative and billing representative duties and responsibilities

Insurance verification representative example responsibilities.

Coach, evaluate and performance manage MSRs to ensure timely and accurate service to clients.
Practice confidentiality while handling patients' medical information with use of the HIPAA law.
Verify Medicare, Medicaid, other government agencies and private insurance for new patients to determine their individualize eligibility and benefits.
Verify HMO referrals and treatment plans are authorize.
Have knowledge in difference between HMO and PPO insurance.
Comply with HIPPA due to the nature of client information.

Billing representative example responsibilities.

Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
Submit and receive Medicare and Medicaid claims electronically on a daily basis.
Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.

Insurance verification representative vs billing representative skills

Common insurance verification representative skills

Patients, 21%
Insurance Verification, 14%
Customer Service, 11%
Medical Terminology, 6%
Insurance Benefits, 4%
Insurance Eligibility, 4%

Common billing representative skills

Patients, 18%
Customer Service, 13%
Data Entry, 6%
Medical Billing, 5%
Medicaid, 5%
Patient Accounts, 4%

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Insurance Verification Representative
Insurance Verification Representative vs Billing Representative

Updated January 8, 2025

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