Medical insurance biller vs medical claims processor

The differences between medical insurance billers and medical claims processors can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 1-2 years to become a medical insurance biller, becoming a medical claims processor takes usually requires 2-4 years. Additionally, a medical claims processor has an average salary of $36,777, which is higher than the $36,575 average annual salary of a medical insurance biller.

The top three skills for a medical insurance biller include patients, medical terminology and appeals. The most important skills for a medical claims processor are patients, healthcare, and data entry.

Medical insurance biller vs medical claims processor overview

	Medical Insurance Biller	Medical Claims Processor
Yearly salary	$36,575	$36,777
Hourly rate	$17.58	$17.68
Growth rate	-3%	-3%
Number of jobs	128,300	59,992
Job satisfaction	-	-
Most common degree	Diploma, 29%	Bachelor's Degree, 29%
Average age	46	44
Years of experience	2	4

Medical insurance biller vs medical claims processor salary

Medical insurance billers and medical claims processors have different pay scales, as shown below.

	Medical Insurance Biller	Medical Claims Processor
Average salary	$36,575	$36,777
Salary range	Between $31,000 And $42,000	Between $29,000 And $45,000
Highest paying City	-	Dover, DE
Highest paying state	-	Delaware
Best paying company	-	Cognizant
Best paying industry	-	Government

Differences between medical insurance biller and medical claims processor education

There are a few differences between a medical insurance biller and a medical claims processor in terms of educational background:

	Medical Insurance Biller	Medical Claims Processor
Most common degree	Diploma, 29%	Bachelor's Degree, 29%
Most common major	Insurance	Business
Most common college	University of Pennsylvania	-

Medical insurance biller vs medical claims processor demographics

Here are the differences between medical insurance billers' and medical claims processors' demographics:

	Medical Insurance Biller	Medical Claims Processor
Average age	46	44
Gender ratio	Male, 10.0% Female, 90.0%	Male, 16.0% Female, 84.0%
Race ratio	Black or African American, 10.7% Unknown, 4.3% Hispanic or Latino, 21.0% Asian, 7.0% White, 56.1% American Indian and Alaska Native, 0.9%	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%
LGBT Percentage	7%	11%

Differences between medical insurance biller and medical claims processor duties and responsibilities

Medical insurance biller example responsibilities.

Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
Work on computer systems Laserfiche and MedFm
Update patient demographic and create new accounts in AS400.
Address student's concerns, work with academic and attendance appeals boards.
Download and organize charts from hospital's website into Laserfiche before coding.
Require the ability to read and analyze EOB's from all insurance companies.

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 insurance biller vs medical claims processor skills

Common medical insurance biller skills

Patients, 26%
Medical Terminology, 5%
Appeals, 5%
Data Entry, 5%
Medicaid, 4%
Insurance Carriers, 4%

Common medical claims processor skills

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

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Medical Insurance Biller
Medical Insurance Biller vs Medical Claims Processor

Updated January 8, 2025

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