How to Hire a Medical Biller for Your Healthcare Practice
A great medical biller is worth their weight in gold. They keep your cash flow healthy, your claims clean, and your accounts receivable from turning into a nightmare. A bad one? They cost you thousands in denied claims, delayed payments, and billing errors that pile up faster than you can fix them.
Our team at 4 Corner Resources has placed hundreds of medical billers in healthcare practices nationwide. We’ve seen how the right hire transforms a practice’s financial health, and the chaos that follows when practices rush into hiring a medical biller without proper vetting.
This guide walks you through the entire process: defining what you actually need, sourcing qualified candidates, and assessing whether someone can do the job before you extend an offer. By the end, you’ll know how to hire a medical biller who actually moves the needle on your practice’s financial performance.
Step 1: Define the Role You Actually Need
Before posting a generic “medical biller wanted” ad, take a hard look at what your practice actually needs. Hiring the wrong type of biller wastes money on training someone who won’t stick around or can’t handle the workload.
Medical biller vs coder vs biller-coder
Medical billers and medical coders perform distinct functions. Understanding the difference helps you target the right candidates.
| Role | Primary Responsibilities | Key Skills Required | Best For |
|---|---|---|---|
| Medical Coder | Reviews clinical documentation and assigns standardized codes (ICD-10, CPT, HCPCS) | Medical terminology, anatomy, payer-specific coding guidelines | Practices with complex procedures or high coding error rates |
| Medical Biller | Submits claims, follows up on unpaid claims, handles payment posting and patient billing | Insurance verification, claim scrubbing, denial management, payer portals | Practices with existing coding support or outsourced coding |
| Biller-Coder | Handles both coding and billing functions | Combined expertise in both areas, dual certifications | Small practices (under 20-25 patients/day) where volume doesn’t justify separate roles |
If your practice sees fewer than 20-25 patients daily, a biller-coder is the most cost-effective option. Larger practices typically separate these roles to improve accuracy and productivity.
In-house vs remote vs outsourced billing
- In-house billers provide direct oversight and real-time communication with clinical staff, making it easier to address urgent issues and maintain close coordination.
- Remote billers significantly expand your candidate pool and often reduce costs, which matters since many experienced billers now prefer remote work.
- Outsourced billing companies handle everything for a percentage of collections (typically 4-10%), but you sacrifice control over the process and lose that personal connection to your revenue cycle.
Solo practitioners without administrative staff may benefit from outsourcing. Practices with 3+ providers typically get better value from in-house or remote billers.
Full-time vs part-time vs contract based on volume
- A full-time biller can typically handle 5,000-7,000 claims per month, making them a good fit for most multi-provider practices.
- Part-time billers work well for smaller practices that see 50-100 patients per week, where the volume doesn’t justify a full-time salary.
- Contract billers make sense when you need temporary coverage during leaves, transitions, or seasonal volume spikes.
If your billing backlog keeps growing or you’re 30+ days behind on submissions, you need more capacity than you think.
Step 2: List the Work That Owns Your Revenue
Here’s where most practices go wrong: they focus on generic tasks rather than the specific work that directly impacts their revenue. Your job description should reflect the real work that affects your practice’s financial health, not just administrative fluff.
Start by listing your biggest billing pain points. Are denials killing your cash flow? Is your accounts receivable aging beyond 90 days? Whatever keeps you up at night should be front and center in your job requirements.
Core medical billing work includes:
- Insurance verification
- Claim submission
- Payment posting
- Denial management
- Accounts receivable follow-up
- Patient billing
- HIPAA compliance
Pro tip: Identify the 3-5 tasks with the greatest financial impact on your practice, then ensure your job description emphasizes those areas.
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Step 3: Set Your Must-Have Requirements
Every practice wants a unicorn: a certified biller with 10 years of experience, knowledge of every specialty, proficiency with every EHR system, and willingness to work for entry-level pay. Odds are, you won’t find that person, so you must focus on the requirements that actually predict success.
- Certifications matter, but not as much as you think. The Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) demonstrates baseline competency; for biller-coders, look for the Certified Professional Coder (CPC) credential. While certifications signal that a candidate has invested in their professional development, they don’t guarantee practical competence.
- Experience requirements should match your practice’s complexity. A solo family practice with straightforward commercial insurance can train a candidate with 1-2 years of billing experience. A multi-specialty surgery center participating in bundled payments needs 5+ years of experience and specific knowledge of surgical billing.
- Software experience matters more than you think. Look for candidates who’ve learned multiple systems; they’ll adapt faster to your platform than someone who’s only ever used one. Don’t reject an otherwise stellar candidate just because they haven’t used your exact EHR; most experienced billers can pick up new systems within 2-3 weeks.
- Specialty experience can be critical depending on your practice. Billing for a dermatology practice differs significantly from billing for a mental health clinic. If your specialty has unique billing requirements, prioritize candidates with that experience. If your billing is relatively straightforward, a strong generalist can quickly learn your specific quirks.
Pro tip: Beyond technical requirements, assess soft skills during interviews. Billers must communicate clearly with frustrated patients, persistently follow up with payers, and resolve issues independently when rejections are unclear.
Step 4: Write a Job Description That Attracts the Right Candidates
Most medical billing job descriptions are terrible; either so vague they could apply to any administrative role, or intimidating walls of requirements that scare away qualified candidates who don’t check every single box.
Your job description serves two purposes: filtering out unqualified applicants and engaging qualified applicants with the opportunity. Here’s how to write one that does both:
- Start with a clear job title that matches what people actually search for. “Medical Biller” or “Medical Billing Specialist” works fine; avoid creative titles that won’t appear in candidate searches.
- Open with 2-3 sentences about your practice that give context: your specialty, number of providers, patient volume, and something that makes you distinctive.
- List 6-8 specific responsibilities using action verbs. Say “Submit 150+ insurance claims weekly to commercial and government payers” instead of “Process insurance claims.” Specificity helps candidates visualize the actual work.
- Separate must-haves from preferred qualifications, and be honest about flexibility. Studies show that women apply only when they meet 100% of requirements, while men apply when they meet 60%. Explicitly stating which requirements are flexible helps attract a more diverse candidate pool.
- Include salary range if possible; transparency filters out candidates whose expectations don’t align with your budget early.
- End with a compelling reason to apply: flexible scheduling, supportive environment, advancement opportunities, or comprehensive benefits. Give candidates a reason to choose you over other opportunities.
Pro tip: Check out our comprehensive guide for detailed guidance on crafting effective job descriptions.
Step 5: Source Candidates in the Right Places
Posting a job description on Indeed or Monster and hoping qualified candidates magically appear doesn’t work in today’s competitive market. You need to actively source candidates where medical billers actually look for jobs.
- Start with healthcare-specific job boards like Health eCareers and Absolutely Health Care. These sites attract candidates who are actively working in healthcare and understand industry-specific terminology, so you’ll get better quality applications than from generalist sites.
- Professional associations are goldmine sources for certified billers. AAPC and AAHAM both have job boards where certified professionals actively search for opportunities. Many local chapters also have career networking groups or email lists where you can post openings.
- LinkedIn is increasingly effective for recruiting healthcare administrative professionals, especially for remote positions. You can search for candidates with specific certifications, experience with certain EHR systems, or who’ve worked in your specialty.
- Don’t overlook your existing network. Ask your current staff whether they know qualified billers who are looking for opportunities. Talk to your colleagues at other practices; medical billing is a relatively small professional community in most markets, and word-of-mouth referrals often yield the best candidates.
Pro tip: If you’re struggling to find qualified candidates or don’t have the bandwidth to manage the search yourself, consider partnering with a healthcare staffing agency.
Step 6: Screen Resumes Like a Revenue Cycle Manager
When medical billing resumes start flooding in, don’t just scan for keywords and years of experience. Screen candidates strategically to identify those who can actually improve your revenue cycle, not just fill a seat.
- Look for results, not just responsibilities. Anyone can list “submitted insurance claims” on their resume. Strong candidates quantify their impact; results indicate they understand how their work affects the practice’s financial health.
- Check for relevant certifications, but don’t overvalue them. A CPB or CMRS certification demonstrates baseline knowledge, but it doesn’t guarantee competence. Use certifications as one data point, not the deciding factor.
- Pay attention to job stability. Medical billing has high turnover, but someone who’s changed jobs every 8-12 months raises red flags. Look for candidates who’ve stayed with a practice for at least 2-3 years and can articulate what they’ve learned in each role.
- Notice technology skills. If a candidate lists experience with your specific EHR or practice management system, that’s a plus. But also look for breadth; someone who’s learned 3-4 different systems will adapt faster than someone who’s only ever used one.
- Don’t automatically dismiss career changers or candidates with employment gaps. Some of the best medical billers we’ve placed came from other industries and brought fresh perspectives. Focus on current skills and capabilities, not whether someone has a perfectly linear career path.
Pro tip: Use a resume screening scorecard to evaluate every candidate against the same criteria, reducing bias and driving data-based decisions.
Step 7: Interview Using Real Billing Scenarios
Standard interview questions won’t tell you if someone can actually handle your billing workload. When you’re serious about hiring a medical biller, you need to dig deeper into scenarios that reveal how candidates think and solve problems.
Ask behavioral questions that uncover past experiences:
- “Tell me about a time you reduced a practice’s denial rate. What was your approach?” forces candidates to explain their methodology, not just claim general expertise.
- “Describe a situation where you had to appeal a complex denial. Walk me through your process step by step” reveals whether they understand appeal procedures and can articulate their work.
Use situational questions to assess judgment:
- “You notice that one insurance company consistently underpays claims for a specific procedure code. How would you investigate and address this?” tests problem-solving skills.
- “A patient calls upset about a bill they thought insurance would cover. How do you handle the conversation?” assesses communication skills and empathy.
Ask technical questions to verify knowledge:
- “What’s the difference between a clean claim and a dirty claim, and what are the most common reasons claims get rejected?” should be easy for experienced billers.
- “How do you handle coordination of benefits when a patient has primary and secondary insurance?” tests whether they understand the process or just submit claims blindly.
Add specialty-specific scenarios where relevant, and assess critical thinking, not just correct answers. Strong candidates explain their reasoning, ask clarifying questions, and acknowledge when they need to research something. Weak candidates give overly simplistic answers or claim to know everything without nuance.
Pro tip: Don’t skip culture fit questions. Medical billers need to work well with your front office staff, communicate effectively with providers, and represent your practice professionally to patients and payers. For more guidance, explore our healthcare interview questions.
Strengthen Your Interview Strategy
Use A Hiring Manager’s Guide to Interviewing to build a consistent, effective, and fair hiring process.
Step 8: Test Skills With a Mini Work Sample
Interviews reveal how candidates talk about billing, but work samples reveal whether they can actually do the job. Before extending an offer, give finalists a 30-45 minute practical assessment using anonymized examples from your practice.
Create a skills test that includes:
Patient scenario
Provide demographic information, insurance details, and clinical documentation. Ask candidates to identify insurance verification issues, determine whether prior authorization is needed, and spot red flags that could lead to denials. You’re assessing basic competency, attention to detail, and logical thinking, not asking them to master your entire workflow.
EOB review
Provide a sample Explanation of Benefits and ask them to post the payment, explain the adjustments, and identify any discrepancies. Strong candidates will notice details such as incorrect patient responsibility amounts or contractual adjustments that don’t align with your contracted rates.
Denial appeal
Provide them with a denied claim and the denial reason, and ask them to outline their appeal strategy: what documentation they’d request, what they’d include in the appeal letter, and how they’d follow up if denied again. Strong candidates should demonstrate persistence and knowledge of the appeals process.
Patient communication
Present a patient billing scenario where insurance paid less than expected and ask how they’d explain it to an upset patient. Listen for empathy, clarity, and problem-solving. Weak candidates will blame the insurance company or use jargon that the patient won’t understand. Strong candidates clearly explain their approach and explore options to resolve the issue.
Pro tip: Pay candidates for their time if the assessment exceeds an hour. Respecting candidates’ time signals that you’re a professional employer who values their expertise.
Step 9: Make the Offer and Close the Candidate
Once you’ve found the perfect candidate, don’t lose them by fumbling the offer or taking too long to decide. Strong medical billers often have multiple opportunities, especially if they’re experienced and certified, so move quickly but thoughtfully.
- Make a competitive offer. Entry-level billers typically earn $35,000-$42,000, experienced billers earn $42,000-$55,000, and senior billers or billing supervisors earn $55,000-$70,000 or more. Check medical biller salaries specific to your market.
- Put it in writing. Include a written offer letter that clearly outlines compensation, benefits, work schedule, start date, and any contingencies like background checks or reference verification. Ambiguity creates doubt and gives candidates reasons to keep exploring other options.
- Highlight the full package. Emphasize your total compensation package, not just base salary. If you offer strong benefits (health insurance, retirement matching, paid time off, continuing education stipends, flexible scheduling), make sure candidates understand the full value.
- Address their concerns. If the candidate mentions needing flexibility for childcare pickup during interviews, explicitly confirm your availability. If they ask about professional development, outline how you support continuing education. Show that you listened and that their priorities matter to you.
- Give them time to decide. Offer a reasonable response deadline, usually 3-5 business days for permanent positions. Don’t pressure candidates into snap decisions they’ll regret, but don’t leave the offer open indefinitely either; uncertainty signals that you’re not confident in your choice.
- Start onboarding immediately after acceptance. Order equipment, set up system access, schedule training, and notify your team. The period between acceptance and the start date is when buyer’s remorse often sets in, so stay engaged with regular check-ins on start date logistics.
Step 10: Onboard for Accuracy and Speed
Your new hire’s first 90 days will determine whether they become productive or another hiring failure. Invest in structured onboarding that balances learning your systems with building confidence through early wins.
Week 1: Systems and shadowing
Give them login credentials for your EHR, practice management system, payer portals, and any other tools they’ll use daily. Have them shadow your current billing process from start to finish without touching anything yet. Create checklists for common tasks such as insurance verification, claim submission, and payment posting so they can reference them when they begin the work themselves.
Weeks 2-4: Hands-on practice with supervision
Start with simple tasks such as insurance verification and payment posting, where errors are easily detected and corrected. Gradually introduce more complex work, like claim submission and denial management. Review their work daily and provide immediate feedback (positive reinforcement when they do things correctly and gentle correction when they make mistakes).
Assign a mentor
Your new biller needs someone they can ask questions without feeling judged. Medical billing involves hundreds of small procedural details that aren’t obvious from documentation, so normalize asking questions rather than guessing.
Set clear 90-day milestones:
- By day 30: Independently handle insurance verification and payment posting
- By day 60: Submit claims with minimal review and start working on accounts receivable
- By day 90: Manage the full billing cycle with decreasing supervision
Put these expectations in writing so everyone knows what success looks like.
Provide specialty-specific training if needed
If you bill workers’ comp, spend dedicated time on lien filing and treatment authorization. If you participate in value-based programs, explain quality reporting requirements. If you have a high self-pay population, train them on payment plan policies and collections procedures.
Create a payer reference document
List your top 10 payers, their quirks, common denial reasons, who to call for issues, and any special billing requirements. Information like “Blue Cross requires pre-auth for procedures over $500” or “Aetna consistently downcodes evaluation visits – appeal with documentation of complexity” saves your new biller months of frustration.
Check in at 30, 60, and 90 days
Use these milestones to assess progress, provide constructive feedback, adjust training as needed, and reinforce what they’re doing well. Also, ask for their feedback on your practice’s processes; fresh eyes often spot inefficiencies that everyone else has accepted as normal.
KPIs to Track After You Hire
Hiring a medical biller is the starting line, not the finish. Track specific metrics to measure whether your new hire is improving your revenue cycle.
| KPI | Target | What It Measures |
|---|---|---|
| Clean Claim Rate | 95%+ | Claims submitted without errors on first attempt |
| Denial Rate | Below 5% | Claims denied by payers |
| Days in A/R | 90 days or less | Time to collect payment from date of service |
| Collection Rate | 95-98% | Actual collections vs. expected reimbursement |
| Time to Submission | 48-72 hours | Lag between service date and claim submission |
Break down denial rates by payer and reason to identify patterns. If one payer denies 20% of claims while others deny 3%, that’s a payer relationship issue, not a biller competency issue.
Set monthly targets and review them regularly with your biller. Use the data for coaching, not punishment. Billers perform better when they understand how their work affects practice finances and receive regular feedback.
Common Mistakes to Avoid
Even experienced practice managers make predictable mistakes when learning how to hire a medical biller. Here are the most common traps and how to avoid them:
- Hiring based on personality instead of competence. A pleasant personality doesn’t translate to billing accuracy or strong follow-through. Prioritize demonstrated skills and results over likeability; you can teach someone your office culture, but you can’t quickly teach them to appeal complex denials or negotiate with insurance companies.
- Skipping the skills test to speed up hiring. You’ll discover competency gaps weeks or months into employment, when fixing the problem is expensive and disruptive. Investing 30-45 minutes in a practical assessment now saves you from a bad hire later.
- Offering below-market compensation. Many practices offer below-market salaries, then wonder why they can’t attract strong candidates. Medical billing is specialized work that directly impacts your revenue. Pay market rates for the experience level you need, or accept that you’ll need to invest heavily in training someone less experienced.
- Failing to define success metrics upfront. Set clear expectations about claim volume, denial rates, and collection targets during onboarding. Regular performance reviews based on objective data keep everyone aligned and accountable.
- Neglecting ongoing training and development. Payer requirements change constantly, new regulations get implemented, and billing best practices evolve. Budget for continuing education, certification renewals, and industry conferences. Investing in your biller’s development pays dividends through improved performance and higher retention.
- Tolerating mediocrity because “they’re better than nothing.” A mediocre medical biller costs you money through errors, missed charges, and inadequate follow-up. If someone isn’t meeting performance standards after 90 days with proper training and support, cut your losses and start the search again. Bad billers are more expensive than vacant positions.
Get Help Hiring a Qualified Medical Biller
Learning how to hire a medical biller who will actually strengthen your revenue cycle takes time, expertise, and often multiple rounds of recruiting before you find the right fit. If you’re struggling to find qualified candidates or want to avoid the costly mistakes that come from rushed hiring decisions, we can help.
At 4 Corner Resources, we specialize in healthcare administration staffing and understand the unique challenges of hiring for medical billing roles. Our recruiters maintain relationships with certified billers who are actively seeking opportunities and can often fill positions faster than practices recruiting on their own.
We handle sourcing, screening, and initial assessment, so you spend time only with candidates who have the technical skills, experience, and cultural fit your practice needs. Whether you need a full-time biller, a part-time specialist, or contract support during transitions, our team can develop a customized solution that works for your budget and timeline.
Contact us today to discuss your medical billing staffing needs and learn how our proven process can help you find a qualified biller who will protect your bottom line.
Frequently Asked Questions
What certifications should I look for when hiring a medical biller?
The most recognized certifications are Certified Professional Biller (CPB) from AAPC and Certified Medical Reimbursement Specialist (CMRS) from AHA. For billers and coders, look for the Certified Professional Coder (CPC) credential. While certifications indicate baseline knowledge, they also assess hands-on experience and quantifiable results from previous roles.
How much should I expect to pay a medical biller?
Entry-level billers earn $35,000-$42,000 annually, experienced billers earn $42,000-$55,000, and senior billers earn $55,000-$70,000+. Salaries vary by location and specialty. Check medical biller salaries for your specific market.
Should I hire a medical biller who can also code, or keep these roles separate?
Practices with fewer than 20-25 patients per day often benefit from billers who handle both functions. Larger practices typically separate billing and coding to improve accuracy and create checks and balances. If you’re experiencing high denial rates due to coding errors, adding a dedicated coder may solve the problem faster.
How do I assess a medical biller’s competency during interviews?
Use practical assessments that simulate real work. Provide patient scenarios with insurance information, then ask candidates to identify billing issues and explain strategies to prevent denials. Present the sample EOBs and ask them to post payments and identify any discrepancies. These hands-on exercises reveal actual capability better than traditional interview questions.
What’s the biggest red flag when reviewing medical biller resumes?
Frequent job changes (every 8-12 months) without clear progression raise reliability concerns. Strong candidates typically stay with practices 2-3+ years and can articulate what they learned in each role. Another red flag is resumes listing only generic responsibilities without quantifiable results; strong candidates demonstrate impact through specific metrics.
