Top 12 Reimbursement Specialist Skills to Put on Your Resume

As a reimbursement specialist, showcasing a sharp, practical mix of skills on your resume matters more than fluff. The right blend helps you cut through the static in a crowded healthcare job market. Below you’ll find 12 essential skills that strengthen a resume, speed up interviews, and support day‑to‑day results.

Reimbursement Specialist Skills

1. ICD-10 Coding
2. CPT Coding
3. HCPCS Coding
4. Medisoft
5. Epic Systems
6. Medical Billing
7. Claims Processing
8. Revenue Cycle Management
9. Microsoft Excel
10. Insurance Verification
11. HIPAA Compliance
12. EHR (Electronic Health Records)

1. ICD-10 Coding

ICD-10 coding classifies diagnoses and inpatient procedures so billing can match documented care. For a Reimbursement Specialist, precision here drives clean claims, fewer denials, and honest revenue capture.

Why It's Important

ICD-10 provides standardized, specific diagnosis and inpatient procedure codes that support accurate billing and regulatory compliance. Cleaner coding means fewer payer questions and faster payments.

How to Improve ICD-10 Coding Skills

Level up with a steady cadence of study and feedback. A few reliable moves:

1. Continuous education: Track annual guideline changes and official coding updates from recognized bodies such as AHIMA and AAPC.

2. Use updated tools: Work with coding software that’s refreshed frequently and includes edits, notes, and guidelines.

3. Deliberate practice: Code real scenarios, then compare against authoritative guidance or peer review results.

4. Workshops and webinars: Short bursts of focused training keep nuance fresh.

5. Feedback loops: Review every denial tied to coding; catalog root causes; close gaps with targeted refreshers.

How to Display ICD-10 Coding Skills on Your Resume

2. CPT Coding

CPT (Current Procedural Terminology) captures physician and outpatient services. It’s the backbone for reporting what was done so insurers can adjudicate correctly.

Why It's Important

Without precise CPT selection and modifiers, claim accuracy crumbles. Correct CPT coding supports compliance, reduces denials, and keeps revenue flowing.

How to Improve CPT Coding Skills

Keep your ear to the ground and your codes current:

1. Stay updated: Review AMA CPT code changes, guidance, and errata each year.
2. Pursue ongoing education: Short micro-learnings and case-based training beat once‑a‑year cram sessions.
3. Leverage coding software: Use tools that surface NCCI edits, bundling rules, and modifier prompts.
4. Audit regularly: Internal spot checks reveal blind spots before payers do.
5. Tighten documentation: Collaborate with providers so notes fully support codes and modifiers.

How to Display CPT Coding Skills on Your Resume

3. HCPCS Coding

HCPCS (Healthcare Common Procedure Coding System), particularly Level II, covers supplies, equipment, and services not fully captured by CPT—think DME, drugs, and ambulance transport.

Why It's Important

Payers depend on HCPCS for consistent billing of supplies and ancillary services. Correct use minimizes denials and speeds reimbursement, especially for Medicare and Medicaid.

How to Improve HCPCS Coding Skills

Set a rhythm and stick to it:

1. Track official updates: Review CMS and professional association bulletins for code and policy changes.

2. Broaden your reference set: Pair code books with payer manuals and internal job aids.

3. Use validation tools: Coding software with current code sets and edits reduces guesswork.

4. Audit often: Focus on high-dollar supplies and injectables—small missteps, big impact.

5. Engage communities: Professional groups (AAPC, AHIMA) surface practical interpretations and tough scenarios.

How to Display HCPCS Coding Skills on Your Resume

4. Medisoft

Medisoft is billing software used to schedule, bill, and submit claims. In the right hands, it trims friction across the revenue cycle.

Why It's Important

It centralizes claim creation, edits, eligibility, and payment posting. Less swivel-chairing, fewer errors, faster cash.

How to Improve Medisoft Skills

Make the tool work harder than you do:

1. Stay current: Keep software and code sets updated to avoid outdated edits.

2. Tune reports: Build custom A/R aging, denial reason, and payer lag dashboards for sharper follow‑up.

3. Go electronic: Submit claims and remits via EDI; reduce paper delays.

4. Automate eligibility: Run real‑time checks to catch coverage gaps before service is rendered.

5. Train in bursts: Short, recurring sessions on new features and workflows compound fast.

How to Display Medisoft Skills on Your Resume

5. Epic Systems

Epic is a widespread EHR with integrated revenue tools. From charge capture to claim status, it ties clinical documentation to billing outcomes.

Why It's Important

Unified data means fewer gaps between documentation and billing. That clarity helps Reimbursement Specialists resolve denials and accelerate payment.

How to Improve Epic Systems Skills

Learn where the revenue lives inside Epic:

1. Master billing modules: Dive into charge review, claim edit workqueues, and payment posting.

2. Use Reporting Workbench: Track denials, lag days, and underpayments; build saved reports for daily action.

3. Get certified or credentialed: Pursue your organization’s Epic training paths for deeper functionality.

4. Join user groups: Internal forums and sanctioned communities surface tips, pitfalls, and build tricks.

5. Automate where possible: Eligibility, prior auth, and claim status workflows can be streamlined with Epic tools your IT team can enable.

How to Display Epic Systems Skills on Your Resume

6. Medical Billing

Medical billing translates clinical encounters into claims, submits them, and follows the money until it lands. Rinse and repeat—with precision.

Why It's Important

Revenue depends on accurate claims, clean submission, and tidy follow‑up. Without it, denials pile up and cash starves.

How to Improve Medical Billing Skills

Sharpen the fundamentals and the metrics will follow:

1. Keep codes current: Watch annual updates for ICD-10, CPT, and HCPCS; update payer rules early.

2. Use strong software: Automate edits, scrubbing, and batch submission to cut manual errors.

3. Tighten communication: Align with clinicians on documentation specifics and common denial triggers.

4. Audit and trend: Review zero‑pay EOBs, underpayments, and recurring denial reasons; fix upstream.

5. Educate patients: Clear estimates, benefits explanations, and payment options reduce downstream disputes.

How to Display Medical Billing Skills on Your Resume

7. Claims Processing

Claims processing confirms eligibility, validates coding, applies payer rules, and moves each claim to payment—or appeal—without stalling.

Why It's Important

It’s the artery for cash flow. Strong processes shrink days in A/R, reduce rework, and protect margins.

How to Improve Claims Processing Skills

Tight systems beat heroics:

1. Automate data capture: Scrub claims before they leave the door; standardize error checks.

2. Stay current on payer rules: Track medical policies, prior auth, and bundling requirements.

3. Elevate data quality: Verify demographics, coverage, and authorizations up front.

4. Invest in training: Short refreshers on edits, modifiers, and payer nuances prevent repeat denials.

5. Strengthen provider collaboration: Close documentation gaps quickly with clear feedback paths.

6. Mine denial data: Rank top denial reasons, fix root causes, and measure impact over time.

How to Display Claims Processing Skills on Your Resume

8. Revenue Cycle Management

RCM tracks the journey from patient registration to final payment. It’s coordination, analytics, and relentless cleanup rolled into one discipline.

Why It's Important

Healthy RCM shortens cash cycles, curbs denials, and surfaces leakage before it becomes loss. It’s how organizations stay solvent while caring for patients.

How to Improve Revenue Cycle Management Skills

Precision processes, constant visibility:

1. Front‑end accuracy: Nail registration, demographics, insurance capture, and financial clearance.

2. Know your payers: Monitor policy changes and preauthorization rules; update internal playbooks quickly.

3. Optimize submissions: Submit daily, scrub thoroughly, and track rejections within 24 hours.

4. Denial management: Standardize appeals, use templates, and escalate systemic issues to providers and coding teams.

5. Leverage tech: Use eligibility checks, rules engines, and automated follow‑ups to reduce manual lift.

How to Display Revenue Cycle Management Skills on Your Resume

9. Microsoft Excel

Excel wrangles data—claims, payments, variances—and turns noise into something you can act on.

Why It's Important

From denial trend pivots to underpayment trackers, Excel accelerates analysis and guides smarter follow‑up.

How to Improve Microsoft Excel Skills

Get comfortable with the tools that move needles:

1. Formulas and functions: Build with VLOOKUP, XLOOKUP, INDEX/MATCH, IF/IFS, SUMIFS, TEXT, and DATE logic.

2. PivotTables and charts: Summarize huge datasets fast; visualize denials, payer lag, and A/R aging.

3. Data validation: Keep inputs clean with lists, ranges, and error prompts.

4. Conditional formatting: Flag outliers—high balances, old claims, recurring denial codes.

5. Macros/VBA: Automate imports, formatting, and routine reconciliations.

6. Analysis ToolPak and Solver: Tackle trend analysis and what‑ifs without exporting elsewhere.

7. Power Query: Transform messy files and stitch multiple data sources into a single, refreshable view.

How to Display Microsoft Excel Skills on Your Resume

10. Insurance Verification

Insurance verification confirms active coverage, benefits, deductibles, prior auth needs, and patient responsibility—before services happen.

Why It's Important

Catching coverage gaps early prevents denials and unhappy surprises. Clean eligibility means cleaner claims.

How to Improve Insurance Verification Skills

Faster checks, fewer misses:

1. Automate eligibility: Use real‑time 270/271 EDI or payer portals to validate benefits and demographics.

2. Standardize scripts: Create checklists for plan types, prior auth triggers, referrals, and coordination of benefits.

3. Document precisely: Record reference numbers, call details, and effective dates in the EHR/PMS.

4. Train continuously: Refresh staff on payer quirks, carve‑outs, and plan exclusions.

5. Analyze exceptions: Review claims denied for eligibility and fix the upstream causes.

How to Display Insurance Verification Skills on Your Resume

11. HIPAA Compliance

HIPAA compliance protects PHI—on paper, in systems, and everywhere it travels—while billing moves forward without risk.

Why It's Important

Trust and legal safety depend on it. Lax controls invite penalties, breaches, and reputational damage.

How to Improve HIPAA Compliance Skills

Make privacy and security everyday habits:

1. Know the rules: Understand Privacy, Security, and Breach Notification requirements as they apply to billing work.

2. Train regularly: Short, role‑based refreshers beat one long annual video.

3. Secure ePHI: Enforce strong access controls, encryption, and audit logs; lock screens and clean desks.

4. Risk analysis: Review technical and administrative safeguards; remediate gaps quickly.

5. Honor patient rights: Provide timely access, amendments, and accounting of disclosures when requested.

6. Incident response: Document, assess, and notify according to policy; drill the process.

7. Update policies: Revise procedures when laws, tech, or workflows change.

How to Display HIPAA Compliance Skills on Your Resume

12. EHR (Electronic Health Records)

EHRs consolidate the clinical story—history, meds, orders, results—and connect it to billing. Less hunting, better documentation, stronger claims.

Why It's Important

Accurate documentation fuels accurate coding. EHRs reduce omissions, align data, and shorten the path from encounter to payment.

How to Improve EHR (Electronic Health Records) Skills

Trim friction, boost clarity:

1. Streamline data entry: Use templates, smart phrases, and pick‑lists to curb typos and variability.

2. Improve interoperability: Ensure connections with clearinghouses, labs, and other systems are healthy and monitored.

3. Train on updates: New releases bring workflow tweaks; quick refreshers prevent slowdowns.

4. Compliance checks: Build prompts for required elements that support billing and medical necessity.

5. Use analytics: Dashboards that spotlight documentation gaps and denial trends help teams correct the record upstream.

How to Display EHR (Electronic Health Records) Skills on Your Resume