Medical record coder vs reimbursement specialist

The differences between medical record 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 record coder and a reimbursement specialist. Additionally, a medical record coder has an average salary of $54,162, which is higher than the $38,273 average annual salary of a reimbursement specialist.

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

Medical record coder vs reimbursement specialist overview

	Medical Record Coder	Reimbursement Specialist
Yearly salary	$54,162	$38,273
Hourly rate	$26.04	$18.40
Growth rate	11%	11%
Number of jobs	51,197	32,292
Job satisfaction	-	-
Most common degree	Associate Degree, 44%	Bachelor's Degree, 40%
Average age	45	45
Years of experience	12	12

What does a medical record coder do?

A medical record coder is responsible for translating medical files and documents to comprehensive files required by insurance companies and other non-medical institutions. Medical record coders disclose all the patients' information on the file, including their treatment procedures, diagnosis, and medications. They serve as the representative of a medical institution to respond to inquiries and concerns, resolve record discrepancies, and submit additional documents as necessary. A medical record coder must have excellent communication skills, as well as extensive knowledge of the medical industry to discuss medical terms accurately and efficiently.

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 record coder vs reimbursement specialist salary

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

	Medical Record Coder	Reimbursement Specialist
Average salary	$54,162	$38,273
Salary range	Between $39,000 And $75,000	Between $29,000 And $49,000
Highest paying City	-	Lynchburg, VA
Highest paying state	-	Virginia
Best paying company	-	Novartis
Best paying industry	-	Pharmaceutical

Differences between medical record coder and reimbursement specialist education

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

	Medical Record Coder	Reimbursement Specialist
Most common degree	Associate Degree, 44%	Bachelor's Degree, 40%
Most common major	Health Care Administration	Business
Most common college	University of Southern California	University of Pennsylvania

Medical record coder vs reimbursement specialist demographics

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

	Medical Record Coder	Reimbursement Specialist
Average age	45	45
Gender ratio	Male, 12.7% Female, 87.3%	Male, 15.2% Female, 84.8%
Race ratio	Black or African American, 10.6% Unknown, 4.2% Hispanic or Latino, 17.0% Asian, 8.6% White, 58.4% 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 record coder and reimbursement specialist duties and responsibilities

Medical record coder example responsibilities.

Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
Obtain medical records through electronic health records (EHR).
Bill all Medicare, Medicaid, BlueCross, PPO claims electronically.
Maintain the strictest confidentiality and adhere to all HIPAA guidelines and regulations.
Code and charge ER records, apply E/M codes, correct billing errors, and code infusion records.
Process all charges receive from outside services to include CPT, ICD-9, or any other necessary information.

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 record coder vs reimbursement specialist skills

Common medical record coder skills

Medical Terminology, 12%
Patients, 12%
CPC, 10%
ICD-10-CM, 10%
Physiology, 8%
AHIMA, 8%

Common reimbursement specialist skills

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

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Medical Record Coder
Medical Record Coder vs Reimbursement Specialist

Updated January 8, 2025

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