Medical coder vs reimbursement specialist

The differences between medical coders and reimbursement specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a medical coder and a reimbursement specialist. Additionally, a medical coder has an average salary of $51,563, which is higher than the $38,273 average annual salary of a reimbursement specialist.

The top three skills for a medical coder include CPC, medical terminology and ICD-10-CM. The most important skills for a reimbursement specialist are patients, customer service, and appeals.

Medical coder vs reimbursement specialist overview

	Medical Coder	Reimbursement Specialist
Yearly salary	$51,563	$38,273
Hourly rate	$24.79	$18.40
Growth rate	11%	11%
Number of jobs	51,316	32,292
Job satisfaction	-	-
Most common degree	Associate Degree, 37%	Bachelor's Degree, 40%
Average age	45	45
Years of experience	12	12

What does a medical coder do?

A medical coder's role is to interpret and analyze a patient's medical record and translate particular details according to the universal medical alphanumeric code. Moreover, a medical coder is primarily responsible for ensuring that the translations are accurate, as this will play a vital factor in processing insurance and receiving treatments. Aside from accuracy, it is also crucial for a medical coder to coordinate with other hospital personnel at all times, especially when there inconsistencies in the records.

What does a reimbursement specialist do?

A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.

Medical coder vs reimbursement specialist salary

Medical coders and reimbursement specialists have different pay scales, as shown below.

	Medical Coder	Reimbursement Specialist
Average salary	$51,563	$38,273
Salary range	Between $37,000 And $70,000	Between $29,000 And $49,000
Highest paying City	Trenton, NJ	Lynchburg, VA
Highest paying state	Hawaii	Virginia
Best paying company	Meta	Novartis
Best paying industry	Health Care	Pharmaceutical

Differences between medical coder and reimbursement specialist education

There are a few differences between a medical coder and a reimbursement specialist in terms of educational background:

	Medical Coder	Reimbursement Specialist
Most common degree	Associate Degree, 37%	Bachelor's Degree, 40%
Most common major	Health Care Administration	Business
Most common college	Stanford University	University of Pennsylvania

Medical coder vs reimbursement specialist demographics

Here are the differences between medical coders' and reimbursement specialists' demographics:

	Medical Coder	Reimbursement Specialist
Average age	45	45
Gender ratio	Male, 13.2% Female, 86.8%	Male, 15.2% Female, 84.8%
Race ratio	Black or African American, 9.2% Unknown, 4.2% Hispanic or Latino, 16.2% Asian, 9.0% White, 60.1% American Indian and Alaska Native, 1.3%	Black or African American, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3%
LGBT Percentage	9%	9%

Differences between medical coder and reimbursement specialist duties and responsibilities

Medical coder example responsibilities.

Manage all EDI relate communication with trading partners and assist to produce all operational documents for all end users.
Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
Manage health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
Manage the outsourced transcription company.
Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
Adhere to regulations with CPT-4, ICD-9-CM and HCPCS coding with medical terminology and effort meet all audit requirements.

Reimbursement specialist example responsibilities.

Manage the EDI clearinghouse rejections.
Process department payroll, order supplies, and manage petty-cash funds.
Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
Manage cases by aggressively directing the litigation process.
Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.

Medical coder vs reimbursement specialist skills

Common medical coder skills

CPC, 11%
Medical Terminology, 8%
ICD-10-CM, 7%
AHIMA, 7%
Patients, 7%
Clinical Documentation, 5%

Common reimbursement specialist skills

Patients, 20%
Customer Service, 9%
Appeals, 6%
CPT, 5%
Medicare, 4%
Medicaid, 4%

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Medical Coder vs Reimbursement Specialist

Updated January 8, 2025

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