Medical claims specialist vs medical billing, receptionist

The differences between medical claims specialists and medical billings, receptionist can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 6-12 months to become a medical claims specialist, becoming a medical billing, receptionist takes usually requires 1-2 years. Additionally, a medical claims specialist has an average salary of $35,706, which is higher than the $34,622 average annual salary of a medical billing, receptionist.

The top three skills for a medical claims specialist include customer service, patients and medicaid. The most important skills for a medical billing, receptionist are patients, medical billing, and data entry.

Medical claims specialist vs medical billing, receptionist overview

	Medical Claims Specialist	Medical Billing, Receptionist
Yearly salary	$35,706	$34,622
Hourly rate	$17.17	$16.65
Growth rate	11%	-3%
Number of jobs	82,897	115,714
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 38%	Associate Degree, 26%
Average age	45	46
Years of experience	12	2

What does a medical claims specialist do?

A medical claims specialist is responsible for gathering and processing the information required to complete the medical insurance claims process. Typical duties include determining covered medical insurance losses, documenting medical claims actions, and resolving claims through approval or denial of documentation. In addition, you will be responsible for maintaining excellent customer service by responding to customer inquiries and following best practices. You will also be responsible for protecting company operations by maintaining the confidentiality of information.

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 specialist vs medical billing, receptionist salary

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

	Medical Claims Specialist	Medical Billing, Receptionist
Average salary	$35,706	$34,622
Salary range	Between $28,000 And $43,000	Between $28,000 And $41,000
Highest paying City	Attleboro, MA	Boston, MA
Highest paying state	Connecticut	Massachusetts
Best paying company	Total Medical Personnel Staffing	University of California, Berkeley
Best paying industry	Government	Technology

Differences between medical claims specialist and medical billing, receptionist education

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

	Medical Claims Specialist	Medical Billing, Receptionist
Most common degree	Bachelor's Degree, 38%	Associate Degree, 26%
Most common major	Business	Health Care Administration
Most common college	University of Pennsylvania	Stanford University

Medical claims specialist vs medical billing, receptionist demographics

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

	Medical Claims Specialist	Medical Billing, Receptionist
Average age	45	46
Gender ratio	Male, 16.7% Female, 83.3%	Male, 9.5% Female, 90.5%
Race ratio	Black or African American, 9.5% Unknown, 4.2% Hispanic or Latino, 17.0% Asian, 8.3% White, 59.8% American Indian and Alaska Native, 1.3%	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	9%	7%

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

Medical claims specialist example responsibilities.

Apply Medicare, Medicaid billing guidelines to achieve maximum reimbursement.
Detail knowledge of medical coding; ICD-9, CPT and HCPCS codes.
Confirm coverage and work with private payers, commercial payers, Medicaid, and Medicare for reimbursement of provide medical services.
Research medical records, compliance requirements and explanations of benefits to resolve accounts payable for Medicare, Medicaid and commercial insurance.
Maintain strict confidentiality/privacy of patients' protect health information in accordance with HIPAA regulations.
Assist in educating new hires in HIPPA laws and training.

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 specialist vs medical billing, receptionist skills

Common medical claims specialist skills

Customer Service, 14%
Patients, 9%
Medicaid, 7%
Medical Billing, 6%
Phone Calls, 6%
Medical Terminology, 5%

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 Specialist
Medical Claims Specialist vs Medical Billing, Receptionist

Updated January 8, 2025

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