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What does an Insurance Billing Specialist do?

Photo of Brenna Goyette
Brenna Goyette
Certified Professional Resume Writer, Career Expert

Published 3 min read

An insurance billing specialist is responsible for submitting insurance claims on behalf of patients and health care providers. They may also be responsible for follow-up on outstanding claims, as well as preparing and sending patient statements.

Insurance Billing Specialist job duties include:

  • Reviewing and processing insurance claims
  • Investigating and resolving claim discrepancies
  • Following up on unpaid claims
  • Processing patient refunds
  • Generating patient statements
  • Updating patient accounts
  • Answering patient inquiries
  • Filing appeals for denied claims
  • Maintaining claim records
  • Posting payments to patient accounts

Insurance Billing Specialist Job Requirements

An Insurance Billing Specialist is responsible for submitting insurance claims on behalf of patients and health care providers. They may also be responsible for following up on unpaid claims, negotiating with insurance companies, and providing customer service to patients. Most Insurance Billing Specialists have at least a high school diploma, although some jobs may require postsecondary education, and many employers prefer candidates who have completed a certified coding program. Many Insurance Billing Specialists have several years of experience working in the medical billing field.

Insurance Billing Specialist Skills

  • Insurance
  • Billing
  • Customer Service
  • Data Entry
  • Microsoft Office
  • 10-Key
  • Typing
  • Organization
  • Time Management
  • Prioritization
  • Attention to Detail

Related: Top Insurance Billing Specialist Skills: Definition and Examples

How to become an Insurance Billing Specialist

In order to become an insurance billing specialist, one must have a high school diploma or equivalent. Many community colleges and technical schools offer certification programs that can be completed in as little as six months. Once you have completed a certification program, you will need to pass a state-administered exam in order to become licensed.

Most insurance billing specialists work in doctor’s offices, hospitals, or other healthcare facilities. They are responsible for submitting insurance claims on behalf of their patients. In order to do this, they must be familiar with the coding systems used by different insurance companies. They must also be able to keep accurate records and follow up on outstanding claims.

The job outlook for insurance billing specialists is good. The aging population is expected to drive growth in the healthcare industry, which will lead to more demand for billing specialists. Those who are able to use computers and software programs effectively will have the best job prospects.

Related: Insurance Billing Specialist Resume Example

Related: Insurance Billing Specialist Interview Questions (With Example Answers)

Editorial staff

Photo of Brenna Goyette, Editor

Editor

Brenna Goyette

Expert Verified

Brenna is a certified professional resume writer, career expert, and the content manager of the ResumeCat team. She has a background in corporate recruiting and human resources and has been writing resumes for over 10 years. Brenna has experience in recruiting for tech, finance, and marketing roles and has a passion for helping people find their dream jobs. She creates expert resources to help job seekers write the best resumes and cover letters, land the job, and succeed in the workplace.

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