Top 12 Insurance Billing Specialist Skills to Put on Your Resume
Hiring managers skim fast. An insurance billing specialist who shows clarity, accuracy, and momentum rises above the noise. Build a resume that spotlights skills that pay the claims, prevent denials, and keep revenue flowing. Precision matters. Speed matters. Compliance matters even more.
Insurance Billing Specialist Skills
- ICD-10
- CPT Coding
- QuickBooks
- HIPAA Compliance
- Medisoft
- Excel
- EHR/EMR
- Claims Processing
- Medical Terminology
- Denial Management
- Revenue Cycle
- Epic Systems
1. ICD-10
ICD-10 is the diagnostic and procedure coding framework used across healthcare. In the U.S., that means ICD-10-CM for diagnoses and ICD-10-PCS for inpatient procedures. It drives medical necessity, risk adjustment, and everything that touches reimbursement.
Why It's Important
Accurate ICD-10 coding supports clean claims, defensible documentation, and correct payment. One wrong character can shift coverage, trigger denials, or distort data used for quality metrics.
How to Improve ICD-10 Skills
Code with context. Read the note, not just the code book. Refresh anatomy and pathophysiology. Review official guidelines with each annual update. Practice by auditing real cases, then compare to final adjudication. Track your most frequent edits and denials—build a personal “error watchlist.” Use encoder/EHR validation tools, but verify edge cases manually. Pair with a peer for periodic code reviews.
How to Display ICD-10 Skills on Your Resume
2. CPT Coding
CPT codes describe services and procedures. They work alongside HCPCS Level II for supplies, drugs, and some services. Updates land yearly; payer rules layer on top. Nuance sits in modifiers and documentation requirements.
Why It's Important
Right CPT, right modifier, right first-time submission. That trifecta speeds payment and slashes back-and-forth with payers. It also keeps you aligned with compliance standards.
How to Improve CPT Coding Skills
Study the annual code set changes before they go live. Build quick-reference sheets for high-volume specialties. Drill on modifier usage (25, 59, X{EPSU}, 24, 57, 95/GT). Crosswalk CPT to payer policies and medical necessity criteria. Perform mini-audits on E/M leveling and time-based coding. Practice from de-identified charts to boost speed and accuracy.
How to Display CPT Coding Skills on Your Resume
3. QuickBooks
QuickBooks handles accounting: receivables, general ledger, reconciliations, reporting. It’s not a claims system, but it’s useful for tying practice management data to books and tracking cash once the ERA hits.
Why It's Important
Clean books reduce confusion around what was billed versus what was collected. That clarity helps you spot payer underpayments, aging trends, and write-offs that need a second look.
How to Improve QuickBooks Skills
Connect bank feeds to reduce manual entry. Map revenue accounts to match payer and service lines, then reconcile against 835 remits. Use classes or locations for multi-site or multi-provider visibility. Customize invoices for non-claim charges with claim or account references. Build AR aging dashboards and schedule reviews. Export/import with your PM/EHR to keep balances aligned.
How to Display QuickBooks Skills on Your Resume
4. HIPAA Compliance
HIPAA sets the rules for safeguarding protected health information. Billing teams touch PHI all day: eligibility checks, claims, appeals, patient statements. Security and privacy are non-negotiable.
Why It's Important
Compliance protects patients and the organization. Violations lead to fines, investigations, and reputational damage. Good controls also prevent operational headaches.
How to Improve HIPAA Compliance Skills
Train often, test knowledge, retrain after incidents. Apply least-privilege access and review it quarterly. Encrypt devices and email that carry PHI. Standardize breach reporting with a clear, timed playbook. Lock down workstation screens, clean desks, and disposal of printed PHI. Document policies, then actually follow them. Audit logs—check them, don’t just store them.
How to Display HIPAA Compliance Skills on Your Resume
5. Medisoft
Medisoft is a practice management and billing platform (now part of CompuGroup Medical). Scheduling, charge entry, claims, payments—streamlined into one system for small to midsize practices.
Why It's Important
When configured well, it speeds charge capture, cleans claims before submission, and organizes follow-ups so money doesn’t languish in limbo.
How to Improve Medisoft Skills
Use templates and required fields to limit bad data at intake. Turn on claim scrubbing rules that match your top payer edits. Build dashboards for real-time claim status, aging, and denial queues. Keep current on version updates—features and security hardening arrive there. Create saved reports for daily deposits, no-response claims, and zero-pays.
How to Display Medisoft Skills on Your Resume
6. Excel
Excel is your Swiss army spreadsheet: tracking AR, reconciling remits, trending denials, slicing payer mix. Fast and flexible when the PM system can’t pivot the way you need.
Why It's Important
It lets you analyze what’s really happening—beyond canned reports. Patterns jump out. So do root causes.
How to Improve Excel Skills
Master functions that matter: XLOOKUP, INDEX/MATCH, SUMIFS, TEXTSPLIT. Build PivotTables with slicers for interactive reporting. Use Power Query to clean 835/837 files and merge multi-source data. Apply conditional formatting to spotlight anomalies. Create data validation to guard inputs. Record simple macros for repetitive steps. Chart trends that drive decisions—days in AR, clean claim rate, denial rate by code and payer.
How to Display Excel Skills on Your Resume
7. EHR/EMR
EHR/EMR systems house the clinical story—diagnoses, orders, notes, medications. Billing depends on that story being accurate, complete, and accessible. Modern systems also support APIs and FHIR-based data exchange, which helps eligibility, prior auth, and quality reporting.
Why It's Important
Cleaner documentation means cleaner codes and faster adjudication. When clinical and billing data align, denials shrink.
How to Improve EHR/EMR Skills
Integrate charge capture tightly with documentation so codes flow naturally from the chart. Enable real-time eligibility and coverage checks. Standardize templates and picklists to reduce free-text chaos. Train providers on documentation that supports medical necessity. Push for interoperability with labs, hospitals, and payers to prevent mismatches that stall claims.
How to Display EHR/EMR Skills on Your Resume
8. Claims Processing
Claims processing covers the journey from charge entry to submission (837), then remittance (835), posting, and follow-up. Every handoff is a chance to win or lose time and money.
Why It's Important
Efficient processing keeps cash steady and providers focused on care, not chaos. Delays ripple. Precision stops the ripples.
How to Improve Claims Processing Skills
Scrub claims before submission with payer-specific edits. Validate patient demographics and coverage upfront. Automate where it’s safe—batch submissions, ERA posting—then review exceptions with care. Monitor clearinghouse rejections daily; fix and resubmit same day. Keep a living library of payer quirks and rules. Track first-pass yield and attack the bottlenecks that drag it down.
How to Display Claims Processing Skills on Your Resume
9. Medical Terminology
The language of medicine—terms, abbreviations, root words. It’s the bridge from chart to code to claim.
Why It's Important
Misread a term and you miscode. Miscoding becomes mispayment or denial. Fluency prevents that cascade.
How to Improve Medical Terminology Skills
Study by system (cardio, neuro, ortho) to build context. Use flashcards for prefixes, suffixes, and common abbreviations. Read clinical notes regularly—then translate them to codes as practice. Build a glossary for your specialty mix. Review confusing look-alikes and sound-alikes to avoid traps.
How to Display Medical Terminology Skills on Your Resume
10. Denial Management
Denial management means preventing avoidable denials, fixing recoverable ones, and learning from both. Reason codes, CARCs/RARCs, CO/PR adjustments—decode them, then act.
Why It's Important
Every recovered dollar matters. More important: preventing the next denial by repairing upstream gaps.
How to Improve Denial Management Skills
Segment denials by type, payer, and root cause. Prioritize high-dollar and high-likelihood reversals. Create appeal templates with evidence checklists and timelines. Close the loop—feed insights back to registration, coding, and providers. Measure success: overturn rate, days to resolution, recurring root causes. Tackle eligibility, prior auth, and documentation denials first—they’re frequent and fixable.
How to Display Denial Management Skills on Your Resume
11. Revenue Cycle
The revenue cycle spans front desk to final dollar: registration, eligibility, authorization, coding, charge capture, submission, posting, patient billing, follow-up. A chain with many links—strength comes from consistency.
Why It's Important
Healthy cycles reduce days in AR, lift net collection rate, and free teams from constant firefighting. Cash flow steadies. Stress drops.
How to Improve Revenue Cycle Skills
Start at the front end: verify coverage and benefits, collect copays, secure prior auth. Drive a high clean-claim rate with edits and education. Track KPIs—days in AR, denial rate, first-pass yield, bad-debt percentage—and review them weekly. Standardize follow-up cadences by payer and balance threshold. Use underpayment detection to catch silent losses. Document processes so performance doesn’t depend on one person.
How to Display Revenue Cycle Skills on Your Resume
12. Epic Systems
Epic runs large chunks of U.S. healthcare. For billing, think Resolute Professional Billing and Resolute Hospital Billing, plus tightly linked scheduling, coding, and reporting tools.
Why It's Important
When you know Epic’s workflows, you move charges faster, spot edits earlier, and track claims with surgical precision. That translates to fewer surprises and smoother revenue.
How to Improve Epic Systems Skills
Learn the specific Epic modules your org uses and master the charge review and claim edit queues. Build smart tools—favorites, macros, routing rules—to cut clicks. Keep pace with upgrade notes; small changes can shift big workflows. Ask for role-based training; Epic certification typically requires employer sponsorship, but targeted build and end-user education pays off. Join internal user groups and swap tips across departments.
How to Display Epic Systems Skills on Your Resume
