Medical claims processor vs medical billing, receptionist

The differences between medical claims processors and medical billings, receptionist can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a medical claims processor, becoming a medical billing, receptionist takes usually requires 1-2 years. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $34,622 average annual salary of a medical billing, receptionist.

The top three skills for a medical claims processor include patients, healthcare and data entry. The most important skills for a medical billing, receptionist are patients, medical billing, and data entry.

Medical claims processor vs medical billing, receptionist overview

	Medical Claims Processor	Medical Billing, Receptionist
Yearly salary	$36,777	$34,622
Hourly rate	$17.68	$16.65
Growth rate	-3%	-3%
Number of jobs	59,992	115,714
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 29%	Associate Degree, 26%
Average age	44	46
Years of experience	4	2

What does a medical claims processor do?

A medical claims processor has working knowledge of medical billing and coding. The qualifications for this position include knowledge of current procedural terminology (CPT) and international classification of diseases (ICD) coding systems. They are responsible for processing claims forms, adjudicating the allocation of deductibles and copays, and following through with adjudication policies to facilitate proper payment of claims.

What does a medical billing, receptionist do?

A medical billing receptionist serves as the main point of contact in a hospital. Their responsibilities revolve around greeting patients and attending to their needs, gathering and maintaining records, and checking-in patients. They also have administrative support tasks such as answering calls and responding to inquiries, arranging appointments and schedules, producing reports, keeping documentation, and handling billing processes, including insurance. Moreover, a medical billing receptionist must be alert and proactive as the conditions in a hospital can be very unpredictable.

Medical claims processor vs medical billing, receptionist salary

Medical claims processors and medical billings, receptionist have different pay scales, as shown below.

	Medical Claims Processor	Medical Billing, Receptionist
Average salary	$36,777	$34,622
Salary range	Between $29,000 And $45,000	Between $28,000 And $41,000
Highest paying City	Dover, DE	Boston, MA
Highest paying state	Delaware	Massachusetts
Best paying company	Cognizant	University of California, Berkeley
Best paying industry	Government	Technology

Differences between medical claims processor and medical billing, receptionist education

There are a few differences between a medical claims processor and a medical billing, receptionist in terms of educational background:

	Medical Claims Processor	Medical Billing, Receptionist
Most common degree	Bachelor's Degree, 29%	Associate Degree, 26%
Most common major	Business	Health Care Administration
Most common college	-	Stanford University

Medical claims processor vs medical billing, receptionist demographics

Here are the differences between medical claims processors' and medical billings, receptionist' demographics:

	Medical Claims Processor	Medical Billing, Receptionist
Average age	44	46
Gender ratio	Male, 16.0% Female, 84.0%	Male, 9.5% Female, 90.5%
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, 9.9% Unknown, 4.3% Hispanic or Latino, 21.9% Asian, 6.8% White, 56.4% American Indian and Alaska Native, 0.8%
LGBT Percentage	11%	7%

Differences between medical claims processor and medical billing, receptionist duties and responsibilities

Medical claims processor example responsibilities.

Enter UB 92 and 1500 HCFA medical claims into computer system manage and process insurance claims.
Manage cases by aggressively directing the litigation process.
Submit medical claims to commercial insurance companies, Medicare, and Medicaid for payment with use of ICD-9 and CPT coding.
Review and verify patient account information against insurance program specifications, analyze surgical procedures and diagnoses using CPT-4 and ICD-9 codes.
Acknowledge and enforces confidentiality in alignment with (HIPPA) guidelines.
Audit encounters and ICD-10 codes to ensure correct coding and maximum reimbursement.

Medical billing, receptionist example responsibilities.

Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Revise CPT codes and ICD-10 codes before submitting to insurance for chiropractic services and durable medical equipment.
Review and research ICD-9 and CPT codes that are denied by payers, and contact physician offices to assist with correction.
Submit secondary insurance claims with primary insurance EOB.
Facilitate medical billing and coding by interfacing with insurance companies and patients to ensure proper billing procedures.
Discuss physicians' choice of E/M level when in question.

Medical claims processor vs medical billing, receptionist skills

Common medical claims processor skills

Patients, 13%
Healthcare, 10%
Data Entry, 10%
Medical Insurance Claims, 9%
Medical Terminology, 6%
Customer Service, 3%

Common medical billing, receptionist skills

Patients, 21%
Medical Billing, 7%
Data Entry, 5%
Customer Service, 5%
CPT, 4%
Medicaid, 4%

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Medical Claims Processor
Medical Claims Processor vs Medical Billing, Receptionist

Updated January 8, 2025

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