Medical Billing and Coding Specialist job description.
A Medical Billing and Coding Specialist translates clinical documentation into standardized codes and manages the billing cycle for healthcare services. They ensure claims are accurate and compliant, follow up with insurers on denials, and support timely reimbursement for the practice or facility.
The Medical Billing and Coding Specialist job description · $29
The full editable .docx — role summary, 8 worked responsibilities, qualifications, and skills, formatted for your letterhead. Delivered to your inbox within 24 hours — usually instantly.
Role: Medical Billing and Coding Specialist Reports to: Billing Manager or Practice Manager
A Medical Billing and Coding Specialist translates clinical documentation into standardized codes and manages the billing cycle for healthcare services. They ensure claims are accurate and compliant, follow up with insurers on denials, and support timely reimbursement for the practice or facility.
- Assign accurate diagnostic and procedural codes from clinical documentation
- Prepare and submit insurance claims to payers
- Review claims for accuracy prior to submission to reduce denials
What's inside the document.
One-paragraph plain-English explanation of the role's outcome and scope.
8 responsibilities phrased the way the work is actually done.
4 qualifications a candidate must have to perform on day 30.
3 qualifications that would make a candidate excellent in year two.
5 skill chips you can copy directly into your ATS.
Billing Manager or Practice Manager
A complete document set.
- Word document (.docx) — fully editable
- PDF — signature-ready
- Google Docs — one-click copy to your Drive
- 12 months of updates to this document
- Commercial-use licence for internal and client work
The work, not the title.
- Assign accurate diagnostic and procedural codes from clinical documentation
- Prepare and submit insurance claims to payers
- Review claims for accuracy prior to submission to reduce denials
- Follow up on denied or unpaid claims and resubmit as needed
- Post payments and reconcile patient accounts
- Communicate with patients regarding billing questions and payment plans
- Maintain compliance with payer requirements and coding guidelines
- Keep current with coding updates and regulatory changes
Required — and what would make a candidate excellent.
- High school diploma or equivalent; associate degree preferred
- Coding certification (e.g., CPC or CCS) or equivalent training
- Working knowledge of ICD-10, CPT, and HCPCS coding systems
- Familiarity with medical billing software and insurance claim processes
- 1+ years of billing or coding experience in a clinical setting
- Experience with a specific specialty's coding requirements
- Knowledge of electronic health record (EHR) systems
Eight steps from download to publish.
- 01Open the Medical Billing and Coding Specialist job description in Word or your one-click Google Docs copy.
- 02Replace placeholders for company name, reporting line, and location with your specifics.
- 03Tighten the summary to one paragraph that names the team's outcome, not just the role.
- 04Edit the responsibilities to match the actual scope of the seat — aim for 6 to 8 items, not 12.
- 05Separate required qualifications from preferred. Required is what a candidate must have to do the work on day 30; preferred is what would make them excellent in year two.
- 06Add salary range guidance using BLS, Payscale, or your own band data — do not copy generic figures.
- 07Have the hiring manager and one peer read it. Cut anything that wouldn't survive a candidate question.
- 08Publish to your ATS, intranet, and external careers page.
The right document at the right moment.
Use this Medical Billing and Coding Specialist job description any time you are opening or reopening a seat at this level. The entry band sets the calibration — copy the document, tighten it to your specific scope, and circulate to the hiring panel before the first interview.
The reporting line (Billing Manager or Practice Manager) and skills list are starting points. Override either if your org structure or stack differs from the norm — the template is a draft, not a contract.
Honest answers before you download.
- Is certification required for this role?
- Many employers require or strongly prefer a recognized coding certification, though some entry-level positions accept candidates completing certification alongside on-the-job training.
- Can this role be performed remotely?
- Yes, many medical billing and coding positions are remote or hybrid, provided the specialist has secure access to the employer's billing and records systems.
Other documents in this neighbourhood.
Medical Biller
A medical biller prepares and submits claims to insurance payers on behalf of healthcare providers, ensuring accurate coding and timely reimbursement.
Medical Coder
A Medical Coder translates clinical documentation into standardized diagnosis and procedure codes used for billing, insurance claims, and health records.
Billing Specialist
A billing specialist prepares, issues, and tracks customer or patient invoices, ensuring accuracy and timely payment collection.
This Medical Billing and Coding Specialist job description is a professionally drafted starting point for your hiring process and is not legal advice. Hiring practice varies by jurisdiction (e.g. pay-transparency laws differ across US states and AU jurisdictions). Adapt this document for your specific location and have employment counsel review any clauses you add before publishing. Salary varies by region, employer type, and experience. Reference BLS or current industry surveys for ranges. Full disclaimer.