who is medical billing specialist

Medical billing profession is the only profession which is survived during the recession and still growing industry.Though Medical billing and Medical coding are in the same industry, by operation both are different.

Usually both process has been outsourced to third party to do the Medical billing and coding services.

Medical coding is the process of converting Medical terms to numeric code and it required Medical knowledge skills.


Medical billing is the process of submitting the claims and get paid behalf of provider. The person who is doing this process will be called Medical billing specialist.

Skill set needed for Medical billing specialist.

1. Computer skills which need to handle multiple software.
2. Office program skills - It will useful when you handling the reports
3. Communication skills - The person has to do talk with many people from client,insurance and patient in order to the claim processed.
4. Grasping power - to know about latest rules from insurance.

Who is Medical billing specialist.

Medical billing specialist is the one who is handling the below process and having well knowledge in each and every process.


* Insurance verification process

* Patient demographic and charge entry process.

* Submitting the claims by electronic as well as paper method. Tracking various claim submission report.

* Payments posting process for insurance as well as patient.

* Denial management.

* Insurance followup management.

* Insurance appeal process.

* Handling patient billing inquiries.

* Patient statement process.

* Preparing monthly reports such as revenue report and account receivable report and as per the provider requirement.


Medical billing is the vast industry, it requires knowledge has to updated in regular interval. Hope i have covered all the aspect of Medical billing specialist.

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