Medical Biller Requirements

By | August 15, 2023
Medical Biller Requirements
You can become a medical biller and build a successful career by fulfilling certain requirements. Image source: txinstitute.

Medical Biller Requirements

This post provides complete information on the requirements you will need to meet to become a medical biller and succeed in your career.

It covers all you need to know about medical biller educational, job, and certification requirements.

Please continue reading:

Medical Biller Requirements for Career Success

Here are major requirements you will be expected to fulfill to become a medical biller, gain a job, and advance in your career:

  1. Medical Biller Educational Requirements

Aspiring medical biller can gain applicable skills by taking the education program below to prepare them for the tasks ahead as a medical biller.

  • High School Diploma: Diploma programs take from nine months to one year to complete. These programs are offered by career colleges and community colleges.

Admission requirements for High School diploma: The individual must have completed High School educational program and must have passed the required courses like Chemistry and Biology.

  • Associate’s degree: In order to be eligible for certain professional certifications, an Associate degree is often required.

Associate’s degree collectively focuses on the foundational educational and technical knowledge needed to acquire entry-level work in a particular field.

An Associate’s degree provides the students with general education curriculum that goes beyond medical billing and coding degree information. Associate’s programs last two years.

Admission requirements for Associate’s degree program: To enlist for this program, you must have graduated from High School and excelled in the required courses.

  • Bachelor’s degree: A Bachelor’s degree offers programs in health information management and health care administration through universities and colleges for candidates that wants to become a medical biller.

This program takes up to four years to complete. Earning a Bachelor’s degree will provide you with greater career opportunity which can qualify you for higher offices such as management positions.

Admission requirements for Bachelor’s degree program: To enroll for this program, the individual should have acquired an Associate’s degree or have a High School diploma certificate.

  1. Medical Biller Job Requirements

The required and preferred skills for the medical biller position you are seeking may include education, job experience and technical skills.

It may also include soft skills and personality traits that are needed for a successful and better performance on the job.

The following are major job requirements for the medical biller position by most recruiters:

  • Bachelor’s degree in Business, Health Care Administration, or Accounting, or in other relevant field.
  • A minimum of 2 years experience as a Medical Biller or in a similar role.
  • Solid understanding of MS Access and other billing software and Electronic Medical Records (EMR).
  • Ability to multitask and manage time effectively is a necessity.
  • Excellent written and verbal communication skills.
  • Remarkable problem-solving skills and organizational abilities.
  • Excellent team work
  1. Medical Biller Certification Requirements

Before exploring medical coding certification requirements, you must have already taken the first step by acquiring the appropriate academic programs and pursuing a satisfying or successful career.

Medical coding certification gives you an advantage and a top up in reaching your goals as a medical biller.

Explore the certificate programs below to know the appropriate certificate to acquire so as to take your career as a medical biller to the next level.

The following are the certificates to consider acquiring as a medical biller:

  • Certified Professional Biller (CPB): This program is different from a certified coding credential, but it reflects on some coding basics, with a core focus on medical billing on the provider side of health care.

Requirements: To become a medical biller, it is recommended to take courses in medical terminology, anatomy, and physiology, and in advance of signing up for the course in order to have a better understanding of the course.

  • Certified Medical Reimbursement Specialist (CMRS): This is a national certification that was particularly designed for professionals in the medical billing industry.

Requirements: To take the exam, which helps you to keep your CMRS credential up to date, you will need to be a member of the AMBA.

Also, to maintain your CMRS certification you will have to earn 15 continuing education units (CEUs) each year along with being a member of AMBA.

To pass the CMRS exam, one must score 85% or higher overall.

  • Certified Coding Associate (CCA): The CCA is an entry level credential impacting quality skills for coding professionals in all healthcare settings, including both inpatient and outpatient.

Requirements: The only academic prerequisite for CCA certification is a high school diploma or GED. Formal training isn’t a necessity.

  • Certified Coding Specialist (CCS): The credentials of a medical coding professional, a Certified Coding Specialist (CCS) or a Certified Professional Coder (CPC) increase the potential for greater salary and a higher position.

Requirements: To obtain the certified coding specialist credential requires completion of a coding training program that includes anatomy and physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate or advanced ICD diagnostic or procedural, and CPT coding.

Medical Biller Duties and Responsibilities

A medical biller’s duties primarily involve submitting their customers or clients’ medical claims to insurance payers and companies, such as Medicare and Medicaid.

The role of medical billers is important to the financial cycle of the healthcare industry, including large medical centers and single-provider practices.

Below are the major duties and responsibilities of a medical biller:

  • They collect delinquent accounts by making payment arrangements with patients; monitoring their payments and following up with patients when failure in payment occurs
  • Collecting and reviewing patient bills for accuracy and completeness, and checking or obtaining any missing information if any
  • Updating cash spreadsheets, invoice, and running collection reports
  • Follows policies and procedures in maintaining work operations; ensure compliance issues are reported promptly and accurately
  • Maintains quality results by following standards
  • Keeps collected information confidential and protects hospital values
  • Takes part in educational programs to improve job knowledge
  • Adheres to professional standards, hospital policies, and procedures, federal, state, and local requirements in ensuring hospital community is served and protected
  • Ensures telephone inquiries from patients or insurance companies concerning assigned accounts are promptly answered.

Also, read Medical Biller Job Description


To become a medical biller, build your career and succeed in it, you will need to fulfill certain requirements, which include education, job, and certification requirements along the way.

This post helps you to understand what these requirements are and how to meet them if you are in the medical billing industry.