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Medical Billing Specialist: Job Overview

By Steve Smith

The information presented here is true and accurate as of the date of publication. DeVry’s programmatic offerings and their accreditations are subject to change. Please refer to the current academic catalog for details.
 

June 22, 2023

5 min read

Medical billing specialists play a pivotal administrative role in the broad, complex and fast-moving healthcare industry. If you’ve thought about pursuing a medical billing and coding career, understanding the duties and responsibilities of a medical billing specialist is an important first step in learning about this exciting career path. 


In this article, we’ll take a closer look at the role, discussing some of the skills required for the job, the projected growth for this occupation and some of the steps you might take as you prepare to pursue this career.

What Does a Medical Billing Specialist Do?

Working for healthcare providers like hospitals, group specialty practices, outpatient surgery centers and in other patient care settings, medical billing specialists are responsible for managing the payment side of the relationship between the provider or healthcare facility and the patient. Their regular duties may include:

  • Insurance claims: Billers submit claims to patients’ insurance carriers using codes that are assigned to each of the medical or diagnostic procedures performed by the provider, and communicate with insurance companies as they track and monitor the status of payments. 

  • Invoicing: Medical billing specialists create patient invoices for any remaining balances over the amount covered by patients’ insurance plans and send them to the patients.

  • Managing payments: In some cases, a medical biller will collect payments from patients and manage patient information to be sure it is kept up to date in the provider’s system.

  • Investigating claims: When insurance claims are denied or a patient has not paid a bill from the provider, the billing specialist will investigate and take the appropriate action to resolve the situation.

How to Become a Medical Billing Specialist

On your journey to pursue a career as a medical billing specialist, you should plan to take a path that includes hands-on training or medical billing and coding education to help you prepare to enter the occupation, and consider earning certifications that verify specific skills involved in this career, or contribute to ongoing professional development.

Pursue your education

The U.S. Bureau of Labor Statistics (BLS) notes that, while a high school diploma or equivalent plus some work experience may be enough to qualify for some positions, many require a postsecondary certificate, associate or bachelor’s degree.

Medical billing programs typically include coursework in medical terminology, health data requirements and standards and medical coding classification systems.

At DeVry, we can help prepare you to pursue career opportunities in medical billing and coding with skills-focused certificate and degree programs like our Undergraduate Certificate Programs in Medical Billing and Coding, our Associate Degree in Health Information Technology or our Bachelor’s Degree Specialization in Health Information Management that not only immerse you in this specialized field but can help you prepare to pursue industry-relevant certifications that may be needed for career entry or advancement.  

Pursue professional certification

As noted by the BLS, employers may prefer to hire medical records specialists who’ve earned certifications or expect them to earn them shortly after being hired. Industry-specific certification programs that apply to medical billing specialists and medical coders help demonstrate the specific skills required for this career, like the Certified Professional Coder (CPC®), offered by the American Academy of Professional Coders (AAPC). This certification is for professional coders who specialize in coding for procedures or services done through a doctor’s office by either a doctor, physician’s assistant or nurse practitioner. Accurate coding ensures that the billing process goes smoothly. 

The Certified Coding Specialist (CCS®) certification administered by the American Health Information Management Association (AHIMA) is seen as the next step in a medical biller and coder’s career journey. This certification is for professionals who use coded data from hospitals or other larger providers to seek reimbursement from government programs like Medicaid and Medicare, or from insurance companies.

At DeVry, our Undergraduate Certificate in Medical Billing and Coding program includes material addressed in the CPC® certification exam. Students who earn an 85% or higher in the Coding Practicum and Review (CPC® Exam) course can earn a voucher for the CPC® exam. The voucher code is valid for 60 days. 

Students enrolled in our Medical Billing and Coding – Health Information Coding (HIC) Undergraduate Certificate program will be able to prepare for the CCS® exam with a CCS® Review (CCS® Exam) course. Students who earn an 85% or higher in the course can earn a voucher for the CCS® exam. The voucher code is valid for 60 days. 

Gain work experience

To gain work experience in medical billing while pursuing your education or certification, you may want to consider applying for an entry-level position in a medical office or provider. This will allow you to gain exposure to the healthcare industry, build your resume and develop contacts that could help you land your first job once you’ve completed your education.

Benefits of Medical Billing and Coding Education

Why learn medical coding along with medical billing skills? Many of the responsibilities of medical coding and medical billing professionals are interrelated, which makes it a good idea to develop skills in both disciplines. For example, it’s important for both medical billers and medical coders to have a thorough understanding of ICD codes so they can apply them to medical records and build accurate reimbursement claims. Depending on the size of the facility you work in, you may have more day-to-day responsibilities that overlap with the responsibilities of a medical coder than you would if you worked at a larger care center where the workforce may be separated out to a greater degree.

Gain a better understanding of the field

Students who study skills in medical coding have the potential to develop a more holistic understanding of how medical coding operates within the healthcare industry. Medical billers who understand the complexity of what each coding system is used for and how the codes are applied may have a more seamless time collaborating with other health information professionals, who use these codes on a daily basis.

Feel empowered in your work 

By studying medical coding conventions and the reimbursement and payment methodologies used in the modern healthcare revenue cycle, students may feel more empowered and capable once they enter the workforce. Knowing both sides of the medical billing and coding coin, they may feel more confident in their abilities, and perform in a more efficient, accurate and productive manner.  

Potential career advancement

Learning medical coding along with billing may also help you to broaden the types of careers you can consider. Along with industry-relevant certifications, a more well-rounded skill set may help you prepare to pursue medical coder or medical biller jobs, may help you stand out to recruiters and hiring managers or may help you pursue advancement within your current organization.  

Medical Billing Specialist Skills

This important healthcare role combines aspects of information technology, healthcare delivery and customer service, requiring medical billers to have a medley of technical and workplace skills like:

  • Computer literacy: Medical billers should be able to work confidently with computers, learn and use new software and access and organize patient information. This is becoming increasingly important as healthcare providers shift to electronic medical records.

  • Math skills: Billers may be required to utilize math skills in a variety of ways as they work on patient accounts and provide financial updates to both patients and their colleagues.

  • Analytical skills: Involving critical thinking and problem-solving, this skill comes into play when billers need to find errors in the billing process, understand insurance claims or review their patients’ financial histories.

  • Customer service: Strong customer service skills allow billers to maintain professionalism when discussing patients’ accounts or navigating difficult situations. Strong interpersonal and communication skills like empathy and active listening are essential here.

  • Attention to detail: Strong organizational skills and the ability to pay attention to the small details are crucial soft, or professional, skills for medical coding and billing specialists, as this job requires thorough documentation of procedures, claims and invoicing.

  • Ethics and Integrity: Like all other professionals working in patient care environments, billers must exercise discretion and act ethically when working with patient records and protect patient confidentiality as required by law.

Medical Billing Specialist Career Outlook

The job growth outlook for medical billing specialists continues to look positive. The BLS projects employment of medical records specialists to grow 8% from 2022 to 2032, with 15,000 job openings each year, on average, over this period.1 This growth is projected on a national level and local growth will vary by location. This projection is not specific to DeVry graduates and may include earners at all stages of their careers and not just entry-level.

The BLS attributes this continued growth to an aging population and a growing prevalence of chronic health conditions, including heart disease and diabetes. As a result, more medical records specialists will be needed to translate patient information and services into documentation for insurance reimbursement and other purposes.

Considering a Career as a Medical Billing Specialist?

If you have the desire to put your skills to work in the healthcare field, becoming a medical billing specialist is just one of several medical billing and coding careers you can explore.

At DeVry, we can help you transform your passion for healthcare into a profession with 100% online certificate and degree programs that can help you gain essential skills which prepare you to pursue industry certifications in this important healthcare specialty. 

When you look to continue your education with us, qualifying credits from our Undergraduate Certificate in Medical Billing and Coding programs can be applied to our Associate Degree in Health Information Technology, allowing you to work toward an eligible higher-level degree program building off of the skills you’ve already acquired.2 

If you want to keep advancing your education at DeVry, qualifying credits from our Associate Degree in Health Information Technology may be applied to our Bachelor’s Degree Specialization in Health Information Management,2 where you will learn healthcare administration, management and leadership skills, as well as how to evaluate and balance costs and benefits within a healthcare setting.

In 2024, DeVry University was ranked among America's Top Online Colleges for an impressive 3 years in a row by Newsweek. DeVry has the highest number of Medical Billing and Coding Certificate program graduates for 5 consecutive years, according to IPEDS.3 Our advanced online programs offer the flexibility you need to fit your education around your life, while providing the skills and knowledge demanded by today's employers. Join the thousands of students who have chosen DeVry.

1Growth projected on a national level. Local growth will vary by location. BLS projections are not specific to DeVry University students or graduates and may include earners at all stages of their career and not just entry level. https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm

2For the MBC certificate program, all but two courses stack into our Associate of Applied Science in Health Information Technology. For the MBC-HIC undergraduate certificate program, all but three courses stack into our Associate of Applied Science in Health Information Technology. For the AHIT program, all but three courses stack into our Bachelor of Science in Technical Management with a Specialization in Health Information Management. Program availability varies by location. At the time of application to the next credential level, an evaluation of qualifying transfer credit will occur and the most beneficial outcome will be applied. Future programmatic changes could impact the application of credits to a future program. Refer to the academic catalog for details. 

3According to completions data from the Integrated Postsecondary Education Data System (IPEDs) for undergraduate certificates between 1-2 years in length categorized under CIP code 51.0707 conferred during academic years 2018-2022.

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