Medical Billing Specialist Job Description
A medical billing specialist job description template covering ICD-10 and CPT coding, the CPC and CPB credentials, and the ATS keywords employers screen for.
This is one of the more measurable entry-level roles in healthcare administration. Where many office jobs are judged qualitatively, billing specialists are typically evaluated against hard production numbers — claims processed per day, denial rate, days in accounts receivable. It is a production job wearing an office job's clothes, and people who like clear, numeric feedback on their own performance tend to do well here.
CPC (Certified Professional Coder) and CPB (Certified Professional Biller), both from AAPC, are the two credentials that actually move the needle in hiring and pay for this role. Plenty of practices hire without either and train on the job, but candidates who already hold one are competing from a real position of strength, especially above the most junior tier — and many employers will help cover the exam fee after six to twelve months on the job as a retention move.
It is worth distinguishing this role from a healthcare data analyst, since both touch the same underlying claims data. A billing specialist works one claim at a time: submitting it, tracking its status, working out why it was denied, and resubmitting it correctly. That is a different skill from the trend analysis an analyst runs across thousands of claims at once, even when the two roles are looking at the exact same numbers.
Calderwick · Raleigh, NC
Full-time · Hybrid
$38,000 – $50,000
About the role
Calderwick is hiring an entry-level Medical Billing Specialist to join our central billing office, which supports several outpatient clinic locations. You will process claims, resolve denials, and follow up with insurance payers on outstanding balances — one claim at a time.
This is a production role more than a project-based one. Most days are spent working a queue: a batch of claims to submit, a batch of denials to correct, and a list of payer follow-up calls to make before the aging report runs again.
What you'll do
- Code and submit claims accurately using ICD-10, CPT and HCPCS coding conventions.
- Review claims for errors before submission, catching problems that would otherwise come back as a denial.
- Work assigned denial queues: identify the reason, correct the claim, and resubmit within payer deadlines.
- Reconcile EOBs (Explanations of Benefits) against billed and paid amounts to catch underpayments.
- Follow up with insurance payers on outstanding claims once they pass a defined aging threshold.
- Verify patient insurance eligibility and coordination of benefits ahead of scheduled visits.
- Respond to patient billing questions and set up payment plans for outstanding balances.
- Maintain accurate documentation on every claim in case it is pulled for an audit later.
What we're looking for
- Zero to two years of medical billing or coding experience, or completion of a billing/coding certificate program.
- Working knowledge of ICD-10 and CPT coding conventions.
- Familiarity with a clearinghouse or medical billing software platform.
- Comfortable with high-volume, detail-heavy daily work without losing accuracy under pace.
- Basic understanding of payer rules and how to read an EOB.
- Strong attention to detail — a single transposed digit can stall a claim for weeks.
Nice to have
- CPC (Certified Professional Coder) or CPB (Certified Professional Biller) certification, completed or in progress.
- Experience with a specific billing platform such as Athenahealth, Kareo, or AdvancedMD.
- Prior experience in a multi-provider or multi-location billing office.
- Customer service experience handling billing disputes or payment plans.
- Familiarity with HIPAA requirements as they apply to handling patient financial and health information.
Benefits
- Medical, dental and vision coverage.
- 401(k) with a 3% company match.
- Two remote days a week once initial training is complete.
- Tuition and exam-fee assistance toward CPC or CPB certification.
- Fifteen days of paid time off plus company holidays.
Salary range
As posted for this sample role. Real pay varies by employer, location and experience.
$38,000–$50,000/ yr
ATS keywords for this role
The applicant tracking system (ATS) — the recruiting software a hiring team searches and filters applicants with — will screen for these. Weight shows how central each one is to this specific posting.
Required and central (4)
Important (6)
Mentioned in passing (6)
Frequently asked questions
Do I need CPC or CPB certification to get hired?
No, not always, especially for an entry-level role like this one. Plenty of practices hire without either and train on the job, then help pay for the exam after six to twelve months as a retention move. That said, candidates who already hold CPC or CPB are competing from a real position of strength, particularly for anything above the most junior tier.
What does a typical day actually look like?
Less like a project and more like a queue. You will usually start with a batch of claims to submit, spend a chunk of the day working denials that came back, and end with payer follow-up calls or portal checks on anything past its aging threshold. Performance is often measured in hard numbers — claims processed, denial rate, days in A/R — which is unusual for an entry-level office role and worth knowing going in.
How is this role different from medical coding?
Coding assigns the diagnosis and procedure codes that describe what happened during a visit. Billing takes that coded claim and manages it through submission, denial and payment. Larger organizations often split the two into separate roles; smaller practices, including postings like this one, frequently combine them into a single billing specialist position.
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