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Medical biller coder skills for your resume and career

Updated January 8, 2025
4 min read
Medical biller coder example skills
Below we've compiled a list of the most critical medical biller coder skills. We ranked the top skills for medical biller coders based on the percentage of resumes they appeared on. For example, 16.9% of medical biller coder resumes contained patients as a skill. Continue reading to find out what skills a medical biller coder needs to be successful in the workplace.

15 medical biller coder skills for your resume and career

1. Patients

Here's how medical biller coders use patients:
  • Obtained patients' medical history and effectively communicated with insurance companies to verify benefits coverage and eligibility of patients.
  • Analyzed patients' records and statements to ascertain appropriate alphanumerical medical code for billing purposes.

2. Medical Billing

Here's how medical biller coders use medical billing:
  • Processed daily medical billing and patient information into computer system * Assisted Nursing Staff with administrative office support
  • Improved efficiency, quality, and productivity by implementing office s first-ever standardized procedures for medical billing.

3. ICD-10

Here's how medical biller coders use icd-10:
  • Managed health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
  • Utilized knowledge of CPT, ICD-9-CM, and ICD-10 to properly translate performed services into numerical code for insurance company reimbursements.

4. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how medical biller coders use customer service:
  • Provided excellent customer service by actively listening to customer information and concerns and taking swift and decisive action on their behalf.
  • Assisted with day-to-day office and customer service operations including scheduling appointments, patient follow-ups, and other administrative functions.

5. CPT-4

Here's how medical biller coders use cpt-4:
  • Interpreted and reviewed medical record documentation to assign accurate CPT-4 procedure and assigned ICD-9 diagnosis codes.
  • Determined codes for procedures and diagnosis - using ICD-9 and CPT-4 coding protocols - for third party billing purposes.

6. HCPCS

Here's how medical biller coders use hcpcs:
  • Support and participate in process and quality improvement initiatives by maintaining updated files for HCPCS, ICD-9, and PQRI codes.
  • Audit claims for accuracy of correct ICD 9, CPT, and HCPCS codes, as well as patient demographics.

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7. Medical Terminology

Here's how medical biller coders use medical terminology:
  • Translate dental terminology to medical terminology to bill medical insurances for certain procedures performed in the dental field.
  • Demonstrated ability to read and comprehend medical record documentation through knowledge of medical terminology and anatomy physiology.

8. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how medical biller coders use data entry:
  • Submit patient and insurance confidential data entry in a secure timely management to ensure accurate and sufficient remittance.
  • Compiled monthly quota report and data entry of bi-monthly validation reports.

9. Medicare

Medicare is a federal government insurance program that offers health care coverage to people who are 65 and above. In some cases, younger people with disabilities whose status is identified by the SSA can also avail the insurance program. Medicare covers the health expenses of people who are not able to afford it plus it protects the payee from rising health care costs.

Here's how medical biller coders use medicare:
  • Reviewed evaluated claims based on Medicare Physician Fee Schedule guidelines and National Correct Coding Initiatives policy manuals.
  • Research Medicare and Commercial insurance denials, or rejections; apply corrections necessary for reimbursement.

10. Medicaid

Here's how medical biller coders use medicaid:
  • Maintain operational and financial reconciliation processes related to claim submissions for Medicaid including reconciliation of financial variances in reimbursements.
  • Make sure Medicare and Medicaid guidelines are followed accordingly for Pain Management billing and collections.

11. EOB

EOB stands for explanation of benefits. This is a common outline provided as part of many health insurance plans to explain what services were completed, the co-pay required for each appointment, and how much of your payment is covered by health insurance. EOB is an indication that your insurance claim has already been processed.

Here's how medical biller coders use eob:
  • Researched and resolved incorrect payments, EOB rejections and provided insurance provider with corrected information.
  • Input into computer system all patient payments and secondary / tertiary insurance claims from Explanation of Benefits (EOB's).

12. Appeals

Here's how medical biller coders use appeals:
  • Verify eligibility and benefits when needed and also do appeals when authorizations have not been obtained.
  • Utilized insurance company websites and portals to research and accurately determine appeals process.

13. Patient Accounts

Patient accounts are a part of a hospital information system that is used for storing financial data, keeping a record of healthcare costs, and providing information regarding patient billing. It deals with the financial aspects of the healthcare setting.

Here's how medical biller coders use patient accounts:
  • Oversee patient accounts, ensuring claims were processed that were deemed medically necessary were adjudicated within timely filing limits.
  • Crated patient accounts, obtained demographic information, authorization/referrals, verified insurance and made sure all was correct.

14. Physical Therapy

Here's how medical biller coders use physical therapy:
  • Experience in Physical Therapy billing and insurance processing and administration,
  • Entered Codes (In Patient and Out Patient for Orthopedics and Physical therapy), claims and submitted claims to insurgencies.

15. Insurance Verification

Here's how medical biller coders use insurance verification:
  • Preformed eligibility and insurance verification.
  • Review insurance eligibility and primary care provider information via online insurance verification system and/or contact carrier to obtain eligibility and benefits.
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List of medical biller coder skills to add to your resume

Medical biller coder skills

The most important skills for a medical biller coder resume and required skills for a medical biller coder to have include:

  • Patients
  • Medical Billing
  • ICD-10
  • Customer Service
  • CPT-4
  • HCPCS
  • Medical Terminology
  • Data Entry
  • Medicare
  • Medicaid
  • EOB
  • Appeals
  • Patient Accounts
  • Physical Therapy
  • Insurance Verification
  • EMR
  • HIPAA
  • Radiology
  • Surgery
  • Insurance Claims
  • Bundling
  • Patient Demographics
  • Patient Payments
  • Front Desk
  • Insurance Carriers
  • Chemotherapy
  • ICD-9-CM
  • Diagnosis Codes
  • Charge Entry
  • Submit Claims
  • Insurance Payments
  • E/M
  • Billing System
  • Hippa
  • Insurance Coverage
  • Insurance Eligibility
  • A/R
  • EHR
  • Procedure Codes
  • CMS-1500
  • Medical Claims
  • Patient Billing
  • Computer System
  • Patient Statements
  • Unpaid Claims
  • Schedule Appointments
  • Patient Data
  • Electronic Claims
  • Delinquent Accounts
  • Patient Charts

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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