Medicare billing specialist vs insurance verification specialist

The differences between medicare billing specialists and insurance verification specialists can be seen in a few details. Each job has different responsibilities and duties. Additionally, a medicare billing specialist has an average salary of $36,773, which is higher than the $33,043 average annual salary of an insurance verification specialist.

The top three skills for a medicare billing specialist include patients, patient accounts and data entry. The most important skills for an insurance verification specialist are patients, insurance verification, and customer service.

Medicare billing specialist vs insurance verification specialist overview

	Medicare Billing Specialist	Insurance Verification Specialist
Yearly salary	$36,773	$33,043
Hourly rate	$17.68	$15.89
Growth rate	-3%	6%
Number of jobs	54,593	71,688
Job satisfaction	-	-
Most common degree	Associate Degree, 34%	Associate Degree, 27%
Average age	46	46
Years of experience	2	-

Medicare billing specialist vs insurance verification specialist salary

Medicare billing specialists and insurance verification specialists have different pay scales, as shown below.

	Medicare Billing Specialist	Insurance Verification Specialist
Average salary	$36,773	$33,043
Salary range	Between $30,000 And $44,000	Between $28,000 And $37,000
Highest paying City	-	Madison, WI
Highest paying state	-	New Hampshire
Best paying company	-	St. Luke's Cataract & Laser Institute
Best paying industry	-	Pharmaceutical

Differences between medicare billing specialist and insurance verification specialist education

There are a few differences between a medicare billing specialist and an insurance verification specialist in terms of educational background:

	Medicare Billing Specialist	Insurance Verification Specialist
Most common degree	Associate Degree, 34%	Associate Degree, 27%
Most common major	Business	Health Care Administration
Most common college	University of Pennsylvania	University of Pennsylvania

Medicare billing specialist vs insurance verification specialist demographics

Here are the differences between medicare billing specialists' and insurance verification specialists' demographics:

	Medicare Billing Specialist	Insurance Verification Specialist
Average age	46	46
Gender ratio	Male, 9.3% Female, 90.7%	Male, 11.4% Female, 88.6%
Race ratio	Black or African American, 10.3% Unknown, 4.4% Hispanic or Latino, 16.5% Asian, 7.9% White, 59.8% American Indian and Alaska Native, 1.0%	Black or African American, 9.3% Unknown, 3.6% Hispanic or Latino, 16.0% Asian, 4.9% White, 66.1% American Indian and Alaska Native, 0.1%
LGBT Percentage	7%	7%

Differences between medicare billing specialist and insurance verification specialist duties and responsibilities

Medicare billing specialist example responsibilities.

Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Resolve billing issues, ensure accuracy re: CPT, HCPCS, ICD-9 codes as applicable.
Expand knowledge with insurance EOB & Tennessee Medicare (handle denials and some occurring problems )
Call Medicare to re-open claims due to date, CPT, units, or other changes.
Used CPT-4 coders/Modifiers, ICD-9 codes, HCPCS codes when applicable for the resolution of claim payments.
Comply with all HIPPA laws.

Insurance verification specialist example responsibilities.

Check CPT and ICD-10 codes with LCD and policies from multiple insurance companies to make sure procedures will be paid.
Support the patient privacy/confidentiality policies and regulations under HIPAA for patients and their medical records.
Confirm correct charges base on HCPCS codes.
Assist callers as well with questions about their benefits, terms and conditions of medical plans, appeals and grievances.
Provide medical record support in the absence of EMR: assist clinics and hospitals in obtaining medical records in appropriate format.
Document outbound communication from providers and veterans.

Medicare billing specialist vs insurance verification specialist skills

Common medicare billing specialist skills

Patients, 20%
Patient Accounts, 6%
Data Entry, 5%
Medicare, 5%
Medicaid, 5%
CPT, 5%

Common insurance verification specialist skills

Patients, 25%
Insurance Verification, 15%
Customer Service, 7%
Insurance Eligibility, 5%
Data Entry, 4%
Medical Terminology, 4%

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Medicare Billing Specialist
Medicare Billing Specialist vs Insurance Verification Specialist

Updated January 8, 2025

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