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.
Medical billing clerk responsibilities
Here are examples of responsibilities from real medical billing clerk resumes:
- 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.
- Post Medicare EFT checks and mail secondary claims to insurance for processing.
- Print CMS-1500 claim forms and submit demographic information, analyze and send electronic claim forms.
- Enter charges for services, electronically submit HCFA's, post payments, bill insurance companies using ICD-9.
- Access, post and process professional charges for pediatric department, ensuring correct CPT and ICD-9 coding procedures are followed.
- Review files, confirming dates and times of service, compare to EOB forms to ensure proper billing to secondary insurance.
- Post payment electronically through NextGen.
- Prepare and mail explanations of benefits to patients' secondary insurance companies.
- Maintain update information to accurately enter patients insurance under the correct financial class.
- Experience in filing claim appeals with insurance companies to ensure maximum entitle reimbursement.
Medical billing clerk skills and personality traits
We calculated that 18% of Medical Billing Clerks are proficient in Patients, Medical Billing, and Healthcare. They’re also known for soft skills such as Communication skills, Math skills, and Organizational skills.
We break down the percentage of Medical Billing Clerks that have these skills listed on their resume here:
- Patients, 18%
Checked Medicaid, Medicare and Prenatal Care Assessment Program patients for eligibility and transferred to appropriate insurance.
- Medical Billing, 10%
Promoted to medical billing support services after 2 years of reception responsibilities and general helper assistance.
- Healthcare, 7%
Utilized healthcare websites to verify health coverage benefits on inpatient and outpatient therapy services.
- Data Entry, 7%
Increased collections by accurate ICD-9/CPT Coding & data entry *Reconciled customer accounts for proper Physician billing to insurance companies
- Customer Service, 6%
Answered incoming customer service lines and fielding to correct departments for scheduling medical transportation and billing questions.
- Medicaid, 5%
Review Medicaid remittance advice for appropriate payments based on specific program requirements and maximum fee schedules.
Most medical billing clerks use their skills in "patients," "medical billing," and "healthcare" to do their jobs. You can find more detail on essential medical billing clerk responsibilities here:
Communication skills. One of the key soft skills for a medical billing clerk to have is communication skills. You can see how this relates to what medical billing clerks do because "financial clerks should be able to explain policies and procedures to colleagues and customers." Additionally, a medical billing clerk resume shows how medical billing clerks use communication skills: "handled insurance preauthorization and communications with owners on ar appeals. "
Math skills. Another essential skill to perform medical billing clerk duties is math skills. Medical billing clerks responsibilities require that "the job duties of financial clerks includes calculating charges and updating financial records." Medical billing clerks also use math skills in their role according to a real resume snippet: "consult agency on cms regulations conduct quantitative/qa on medical records. "
Organizational skills. Another skill that relates to the job responsibilities of medical billing clerks is organizational skills. This skill is critical to many everyday medical billing clerk duties, as "financial clerks must be able to arrange files so they can find them quickly and efficiently." This example from a resume shows how this skill is used: "contributed as an effective team member by establishing new patient accounts in accordance with organizational procedures and practices. "
The three companies that hire the most medical billing clerks are:
- Rotech Healthcare
4 medical billing clerks jobs
- MTBC2 medical billing clerks jobs
- Robert Half2 medical billing clerks jobs
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Compare different medical billing clerks
Medical billing clerk vs. Patient access representative
A Patient Access Representative is the first point of contact of a patient in a hospital facility. Among the duties include the checking-in and out of a patient, gathering a patient's information for the Doctors and Nurses to use, communicates with the patient's family or caregivers, and processes insurance billing. Most of the time, A Patient Access Representative encounters the critically ill or injured which is why one must possess great communication skills and compassion.
While similarities exist, there are also some differences between medical billing clerks and patient access representative. For instance, medical billing clerk responsibilities require skills such as "medical billing," "healthcare," "medical claims," and "eob." Whereas a patient access representative is skilled in "patient care," "patient registration," "physician orders," and "insurance benefits." This is part of what separates the two careers.
Patient access representatives earn the highest salaries when working in the health care industry, with an average yearly salary of $33,319. On the other hand, medical billing clerks are paid more in the health care industry with an average salary of $34,137.On average, patient access representatives reach similar levels of education than medical billing clerks. Patient access representatives are 2.0% more likely to earn a Master's Degree and 0.1% less likely to graduate with a Doctoral Degree.Medical billing clerk vs. Patient representative
A patient representative is responsible for assisting the patients with their health care needs by identifying their medical concerns, assessing their medical history, and referring them to the appropriate physicians or other medical professionals for immediate treatments and further examinations. Patient representatives verify the patients' insurance information, guiding them on filling out medical forms, processing payments for medical services, and updating them for the release of medical results. A patient representative must have excellent communication and organizational skills, especially when responding to patient's inquiries and concerns timely and accurately, and performing additional administrative and clerical tasks as needed.
Each career also uses different skills, according to real medical billing clerk resumes. While medical billing clerk responsibilities can utilize skills like "healthcare," "medical claims," "appeals," and "cpt-4," patient representatives use skills like "check-in," "patient care," "telephone calls," and "patient flow."
Patient representatives may earn a lower salary than medical billing clerks, but patient representatives earn the most pay in the non profits industry with an average salary of $34,572. On the other hand, medical billing clerks receive higher pay in the health care industry, where they earn an average salary of $34,137.Average education levels between the two professions vary. Patient representatives tend to reach similar levels of education than medical billing clerks. In fact, they're 2.6% more likely to graduate with a Master's Degree and 0.1% more likely to earn a Doctoral Degree.Medical billing clerk vs. Insurance coordinator
An insurance coordinator is responsible for evaluating and validating insurance information to verify claims and process the necessary claims resolutions for parties. Insurance coordinators submit claims statements timely to the insurance officers for review, coordinate with the clients for inquiries and updates, and reach out to medical institutions for accurate filing of payments. An insurance coordinator must have excellent communication and analytical skills to assess reports, resolve claims discrepancies, and escalate high-level complaints to the officers for immediate action.
The required skills of the two careers differ considerably. For example, medical billing clerks are more likely to have skills like "healthcare," "appeals," "cpt-4," and "icd-10." But a insurance coordinator is more likely to have skills like "strong customer service," "health insurance," "insurance benefits," and "patient care."
Insurance coordinators earn the best pay in the pharmaceutical industry, where they command an average salary of $33,609. Medical billing clerks earn the highest pay from the health care industry, with an average salary of $34,137.Most insurance coordinators achieve a similar degree level compared to medical billing clerks. For example, they're 2.1% more likely to graduate with a Master's Degree, and 0.2% more likely to earn a Doctoral Degree.Medical billing clerk vs. Patient care representative
PCRs (Patient Care Representatives) are given responsibilities like updating and verifying patient information after every visit, scheduling and reminding patients about appointments, and informing patients about delays and how long the estimated waiting times will be. They are also responsible for obtaining patients' personal information like their address, contact details, insurance information, and medical and surgical history. They must be able to communicate with patients, family members, and medical staff to give them all the information they need to treat the person looking for medical help.
Types of medical billing clerk
Updated January 8, 2025
