Reimbursement specialist vs billing representative

The differences between reimbursement specialists and billing representatives can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 6-12 months to become a reimbursement specialist, becoming a billing representative takes usually requires 1-2 years. Additionally, a reimbursement specialist has an average salary of $38,273, which is higher than the $35,002 average annual salary of a billing representative.

The top three skills for a reimbursement specialist include patients, customer service and appeals. The most important skills for a billing representative are patients, customer service, and data entry.

Reimbursement specialist vs billing representative overview

	Reimbursement Specialist	Billing Representative
Yearly salary	$38,273	$35,002
Hourly rate	$18.40	$16.83
Growth rate	11%	-3%
Number of jobs	32,292	95,425
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 40%	Bachelor's Degree, 30%
Average age	45	46
Years of experience	12	2

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.

What does a billing representative do?

A billing representative assists with the overall operations of the organization's billing department. Billing representatives post payments timely on the database, update account statements, generate financial reports, release invoices, and resolve account discrepancies. They also perform client accounts reconciliation as needed, monitor account receivables, review overdated balance, and notify clients of payment updates to ensure accurate and timely billing. A billing representative must have strong analytical and communication skills to manage clients' accounts, as well as comprehensive knowledge on the accounting industry to explain the payment terms and policies of an organization to a client.

Reimbursement specialist vs billing representative salary

Reimbursement specialists and billing representatives have different pay scales, as shown below.

	Reimbursement Specialist	Billing Representative
Average salary	$38,273	$35,002
Salary range	Between $29,000 And $49,000	Between $28,000 And $42,000
Highest paying City	Lynchburg, VA	Worcester, MA
Highest paying state	Virginia	Massachusetts
Best paying company	Novartis	Relevante
Best paying industry	Pharmaceutical	Technology

Differences between reimbursement specialist and billing representative education

There are a few differences between a reimbursement specialist and a billing representative in terms of educational background:

	Reimbursement Specialist	Billing Representative
Most common degree	Bachelor's Degree, 40%	Bachelor's Degree, 30%
Most common major	Business	Business
Most common college	University of Pennsylvania	Stanford University

Reimbursement specialist vs billing representative demographics

Here are the differences between reimbursement specialists' and billing representatives' demographics:

	Reimbursement Specialist	Billing Representative
Average age	45	46
Gender ratio	Male, 15.2% Female, 84.8%	Male, 15.7% Female, 84.3%
Race ratio	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%	Black or African American, 10.4% Unknown, 4.3% Hispanic or Latino, 19.9% Asian, 7.3% White, 57.2% American Indian and Alaska Native, 0.9%
LGBT Percentage	9%	7%

Differences between reimbursement specialist and billing representative duties and responsibilities

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.

Billing representative example responsibilities.

Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
Submit and receive Medicare and Medicaid claims electronically on a daily basis.
Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.

Reimbursement specialist vs billing representative skills

Common reimbursement specialist skills

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

Common billing representative skills

Patients, 18%
Customer Service, 13%
Data Entry, 6%
Medical Billing, 5%
Medicaid, 5%
Patient Accounts, 4%

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Reimbursement Specialist
Reimbursement Specialist vs Billing Representative

Updated January 8, 2025

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