Insurance verification representative vs medical billing clerk

The differences between insurance verification representatives 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 verification representative, becoming a medical billing clerk takes usually requires 1-2 years. Additionally, a medical billing clerk has an average salary of $33,566, 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 medical billing clerk are patients, medical billing, and healthcare.

Insurance verification representative vs medical billing clerk overview

	Insurance Verification Representative	Medical Billing Clerk
Yearly salary	$32,706	$33,566
Hourly rate	$15.72	$16.14
Growth rate	-4%	-3%
Number of jobs	150,260	164,870
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 28%	Associate 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 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 verification representative vs medical billing clerk salary

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

	Insurance Verification Representative	Medical Billing Clerk
Average salary	$32,706	$33,566
Salary range	Between $28,000 And $37,000	Between $27,000 And $40,000
Highest paying City	Charleston, WV	San Leandro, CA
Highest paying state	Massachusetts	Washington
Best paying company	Student Conservation Association	iCare
Best paying industry	Health Care	Health Care

Differences between insurance verification representative and medical billing clerk education

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

	Insurance Verification Representative	Medical Billing Clerk
Most common degree	Bachelor's Degree, 28%	Associate Degree, 30%
Most common major	Business	Health Care Administration
Most common college	Stanford University	Stanford University

Insurance verification representative vs medical billing clerk demographics

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

	Insurance Verification Representative	Medical Billing Clerk
Average age	40	46
Gender ratio	Male, 15.1% Female, 84.9%	Male, 11.3% Female, 88.7%
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, 21.9% Asian, 6.8% White, 55.8% American Indian and Alaska Native, 0.8%
LGBT Percentage	7%	7%

Differences between insurance verification representative and medical billing clerk 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.

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 verification representative vs medical billing clerk skills

Common insurance verification representative skills

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

Updated January 8, 2025

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