Billing and Posting Clerks Salary

The median billing and posting clerks salary in the United States is $48,500 per year ($23.32/hour). Salaries range from $37,290 at the entry level to $67,710+ for the top 10% of earners. There are 404,060 billing and posting clerks jobs nationwide. Employment is projected to decline 0.4% through 2034.

Last updated: June 2026 Β· Source: U.S. Bureau of Labor Statistics

Median Salary
$48,500
per year
Hourly Rate
$23.32
per hour
Employment
404,060
jobs in the U.S.

Salary Distribution

10th percentile
$37,290
25th percentile
$42,840
Median
$48,500
75th percentile
$58,290
90th percentile
$67,710

Job Growth (2024-2034)

-0.4%
Decline

Annual Openings

42,200
jobs/year (growth + replacements)

Education Required

High school diploma or equivalent

Training Needed

Moderate-term on-the-job training

Billing and Posting Clerks Career Guide

Interview questions, resume templates, and a career ladder written specifically for billing and posting clerkss.

Billing and posting clerks (also called medical billing specialists, accounts receivable clerks, patient account reps, or legal billing coordinators) generate invoices, post payments, follow up on aging accounts, and process insurance claims. They work inside Epic Resolute, Cerner Millennium, or Meditech at hospital revenue cycle departments; Kareo, AdvancedMD, or Athenahealth at physician offices; and Aderant, Elite 3E, or LEDES-format systems at law firms. Median $48,500 across 404,060 workers; p10 $37,290 at entry small-office roles, p90 $67,710 at senior medical AR specialists at Optum360 / R1 RCM / HCA, and CMRS-certified staff at hospitals and BigLaw firms. Certification (CPB or CMRS) plus 3-5 years in a specialty pays 25-40% above entry.

Core Skills Hiring Managers Screen For

CPT, ICD-10, and HCPCS Level II coding basics
Medical billing clerks read the charge slip / superbill: CPT-4 procedure codes (99213 office visit, 99283 ER visit), ICD-10-CM diagnosis codes (E11.9 Type 2 diabetes, M54.5 low back pain), HCPCS Level II supplies + drugs (J1885 Toradol injection). Know when to query the coder vs. accept the charge as-is.
Insurance verification & eligibility (270/271 EDI)
Before the visit β€” verify active coverage, copay, deductible remaining, out-of-pocket max, in-network status, prior authorization requirements. Availity, Change Healthcare, or payer portal. A denied claim from bad eligibility is 100% preventable.
Claim submission via 837 EDI + clearinghouse (Waystar, Change Healthcare, Availity)
Submit 837P (professional) or 837I (institutional) claims to Medicare, Medicaid, commercial payers. Clean-claim rate 95%+ is the target; every rejection at the clearinghouse costs 2-4 days of AR delay.
Payment posting (ERA 835 + manual EOB posting)
Post electronic remittance advice (ERA 835) auto-matched to claims; manually post paper EOBs (explanation of benefits) at smaller practices. Reconcile the payer allowed amount, patient responsibility (deductible / coinsurance / copay), adjustments (contractual write-off), and denials. Post to patient account within 24-48 hours of receipt.
AR aging management (30-60-90-120+ buckets)
Standard AR aging report shows outstanding claims by age bucket. Work 30-60 aggressively β€” that's where recovery is easiest. 60-90 requires payer follow-up calls, appeals, reconsideration requests. 120+ is often uncollectible without a formal appeal or patient collections referral. Days-in-AR (DIA) under 45 is the industry benchmark.
Denial management + appeals
Read the CARC / RARC codes (Claim Adjustment Reason / Remittance Advice codes) β€” CO-45 contractual, CO-16 missing info, CO-97 bundled, CO-50 not medically necessary, CO-197 pre-auth required. Refile with corrections, submit formal appeal with medical records, or write off if payer position holds. Denial rate under 5% clean-claim is the target.
Patient billing + collections workflow
Patient statement after insurance adjudicates β€” 30 / 60 / 90 day statements, then collections call, then payment plan option (typically 3-24 months at 0% at hospitals), then referral to third-party collections if unpaid at 120+ days. Financial assistance / charity care screening for uninsured or underinsured β€” hospitals are federally required to offer this and screen for it upfront.
Legal time-billing (LEDES 1998B/2000, Aderant, Elite 3E) for law firm billing clerks
Attorney time entries in 6-minute increments, billed to matter numbers, formatted per client billing guidelines (Outside Counsel Guidelines β€” OCGs). LEDES electronic invoice format submitted to e-billing portals (LegalTracker, Serengeti, Passport, TyMetrix 360). Rejection resolution for OCG violations.

How to Become a Billing and Posting Clerks

  1. 1
    Get a high school diploma; associate degree preferred at hospitals and BigLaw firms
    Some hospitals now require an AA in Medical Billing / Coding or Health Information Technology. Community-college programs run 12-24 months and $3-8k total. Not required at physician offices or small law firms.
  2. 2
    Complete a medical billing certificate program (or in-house training)
    AAPC (American Academy of Professional Coders) offers Certified Professional Biller (CPB) β€” $499 exam + $299/yr membership. AMBA (American Medical Billing Association) offers Certified Medical Reimbursement Specialist (CMRS) β€” $399 exam. Either is the standard entry credential.
  3. 3
    Start at a physician office, small hospital, or professional-services firm
    $37-45k entry. Learn one specialty's EMR / billing system deeply β€” Epic Resolute, Cerner Millennium, Athenahealth, Kareo, AdvancedMD. First-year billing clerks focus on payment posting and denial follow-up, moving to full claim submission by year 2.
  4. 4
    Move to specialty billing (surgery, radiology, oncology, DME) or a hospital-based RCM role at year 3-5
    $48-60k. Specialty billing pays 10-15% more because CPT / modifier complexity is higher. Optum360, R1 RCM, and Change Healthcare (Conifer) run large hospital RCM contracts β€” hire experienced billers at $50-65k. Law firm billing coordinators at BigLaw pay $55-72k for LEDES + e-billing fluency.
  5. 5
    Advance to Sr Billing Specialist β†’ Billing Supervisor / RCM Analyst β†’ Revenue Cycle Manager
    $60-95k+. Add HFMA CRCR (Certified Revenue Cycle Representative) or AAPC CRCS. Managers own 8-25 billers, monthly close, AR reporting, payer contract analysis. Directors of Revenue Cycle at hospital systems earn $95-140k.

Career Progression

Billing Clerk / Medical Billing Specialist / AR Clerk (entry)
0-2 yrs$37,290-$48,500 ($18-23/hr; higher at hospital + BigLaw with benefits)
  • β€’Post ERA 835 electronic remittance and manual EOBs to patient accounts
  • β€’Verify insurance eligibility (270/271) for scheduled visits or matters
  • β€’Submit clean 837 claims via clearinghouse (Waystar, Change Healthcare, Availity)
  • β€’Work 30-60 day AR aging follow-up β€” call payers, refile claims, correct errors
  • β€’Generate patient statements + take incoming patient billing calls
Next: Sr Billing Specialist at 2-4 years once you know your specialty's payer mix.
Sr Billing Specialist / Denials + Appeals Specialist / Legal Billing Coordinator
2-5 yrs$48,500-$62,000 ($23-30/hr; higher at Optum360 / R1 / hospital + BigLaw)
  • β€’Own denial management workflow β€” read CARC / RARC codes, appeal at Level 1 and Level 2
  • β€’Work 60-120 day AR aging β€” the tough bucket, biggest recovery upside
  • β€’Legal billing: prepare LEDES invoices, resolve OCG rejections, work e-billing portals
  • β€’Coach entry-level billers on payer-specific requirements + modifier rules
  • β€’Own monthly close for one payer category (Medicare, Medicaid, commercial)
Next: Billing Supervisor / RCM Analyst at 4-7 years.
Billing Supervisor / RCM Analyst / Sr Legal Billing Coordinator
4-8 yrs$58,000-$78,000
  • β€’Supervise a team of 5-15 billers, own daily productivity + quality metrics
  • β€’Run monthly AR review with the CFO / practice manager / firm CFO
  • β€’Own payer-contract analysis β€” allowables vs. actual reimbursement, underpayment recovery
  • β€’Manage the clearinghouse relationship, work rejection resolution at scale
  • β€’Lead the annual coding + fee schedule update cycle
Next: Revenue Cycle Manager / Billing Manager at 7-12 years.
Revenue Cycle Manager / Billing Manager / Director of Revenue Cycle
8+ yrs$78,000-$140,000+
  • β€’Own the entire revenue cycle β€” pre-registration, coding, charge capture, claims, AR, cash posting, patient billing, collections
  • β€’Report DIA (days in AR), denial rate, clean-claim rate, net collection rate to executive leadership monthly
  • β€’Manage 25-100+ billing / coding / AR staff across multiple practice sites or hospital campuses
  • β€’Own payer contract negotiations (with legal / CFO), technology stack, RCM outsourcing vendor management
  • β€’Drive KPI improvements: DIA target < 45 days, clean claim rate > 95%, denial rate < 5%, net collection rate > 96%
Next: VP Revenue Cycle at 12-18 years; CFO track at hospital systems.

Interview Questions & Answers

5 free questions below. Career Kit unlocks 13 total plus resume bullets for every level.

Q1. Walk me through what you do when a claim is denied for CO-16 (missing / invalid information).technical
CO-16 is the most common denial reason and it's fully recoverable. Step 1: read the RARC (Remittance Advice Remark Code) attached to the CO-16 β€” that tells you what's actually missing. Common RARCs: MA130 (invalid claim data), M119 (missing NDC), N56 (procedure code invalid for date of service). Step 2: pull the original 837 submission and compare to what the payer received. Step 3: correct the missing field in the EMR (subscriber ID, DOB, taxonomy code, NDC on a J-code, referring provider NPI, whatever it is), refile the claim as a corrected claim (frequency code 7 on the 837), and note the follow-up in the payer log. Step 4: if the correction is upstream (registration or coder), send it back to that department with the specific fix needed. Target turnaround under 5 business days.
Q2. What's the difference between a contractual adjustment and a write-off?technical
Contractual adjustment is the difference between the provider's charge and the payer's contracted allowed amount β€” it's the negotiated discount the payer already knows about and the practice already agreed to. Posted as a CO-45 (charge exceeds fee schedule) contractual on the 835. Not recoverable, never appealed. A write-off is different β€” it's when the practice decides to eliminate remaining balance for a specific reason: patient financial hardship, small-balance write-off under $5, bad-debt after collections, or timely-filing exhausted. Write-offs need a supervisor approval and get coded to a specific reason code in the EMR for reporting. Never confuse the two on posting β€” a contractual is automatic and expected, a write-off is a decision.
Q3. How do you prioritize a 400-line AR aging report on a Monday morning?situational
Work high-dollar, high-recoverability first. Sort the report by (1) balance descending, then (2) age ascending within balance bracket. Focus on 60-90 day claims $500+ first β€” highest recovery per unit of effort. Then 30-60 day claims $1000+. Then 90-120 day. Skip 120+ unless there's a specific new development (patient re-registered, insurance found retroactively). Group calls by payer to save on hold time β€” call Blue Cross once and work 15 accounts, not 15 separate calls. Log every touch (call, refile, appeal) in the AR notes so the next person can pick up cleanly. Metric to hit: 60-80 accounts worked per day at entry, 120-150 at senior level.
Q4. What EMR / billing system are you strongest in and why?technical
Real answer: pick one, be specific about what you can do end-to-end. Example strong answer: 'Epic Resolute β€” I worked there 3 years at a hospital-owned family medicine group. I can build a claim, post ERA 835 batches, work SBO (single billing office) work queues, appeal denials in the Resolute workqueue, generate patient statements, and run the standard AR aging + denial reports. I know Reporting Workbench well enough to build my own denial reason reports.' Weak answer: 'I've used Epic and Cerner and Kareo.' Managers want depth in one, not surface exposure across many.
Q5. A patient calls in upset about a $1,200 bill they didn't expect. How do you handle it?situational
First β€” never argue. Pull the account, review the visit / procedure, verify insurance was billed and adjudicated correctly. Explain in plain language: what the charges were for (e.g., 'you had an office visit + a lab panel + a joint injection'), what insurance paid ('your plan applied $850 to your deductible, then paid 80% of the remaining $350'), and what the patient owes ('the $1,200 is your deductible + coinsurance for the visit'). Offer the payment options the practice has: pay in full for a small discount (typically 5-10% cash pay), payment plan (3-24 months at 0% at most hospitals), financial assistance / charity care application (federal requirement at 501(c)(3) hospitals). Never promise a specific reduction without supervisor approval. Document the call in the account notes with a callback date if the patient is undecided.

Resume Template β€” Billing Clerk / Medical Billing Specialist / AR Clerk (0-2 yrs)

Copy these bullets into your resume as a starting point. Career Kit includes bullets for every level of the ladder.

Billing Clerk / Medical Billing Specialist / AR Clerk (0-2 yrs)
  • β–ΈPosted 250-350 ERA 835 remittances daily to Epic Resolute for a 12-provider family medicine group; maintained 99.4% posting accuracy against monthly QA review.
  • β–ΈWorked 30-60 day AR aging bucket β€” recovered $185k in FY24 by refiling corrected claims and calling payers on high-dollar accounts.
  • β–ΈAAPC Certified Professional Biller (CPB); trained in ICD-10-CM, CPT-4, HCPCS Level II, and CARC / RARC denial codes.
  • β–ΈReduced Blue Cross denial rate 8.2% β†’ 4.9% in 6 months by fixing the taxonomy-code error upstream at registration.

What Gets You Rejected

  • βœ—Doesn't know ICD-10, CPT, or HCPCS conventions β€” medical billing clerks have to at least read codes fluently even if they don't code.
  • βœ—Poor AR follow-up β€” 90+ day AR balance grows month over month, cash flow tanks, the practice or firm suffers.
  • βœ—Sloppy payment posting β€” misapplied payments to wrong patient accounts, credit balances go unreconciled, month-end close breaks.
  • βœ—Rude or defensive on patient billing calls β€” a single unpaid $500 bill isn't worth a Google review that drops the practice's rating.
  • βœ—Doesn't stay current on payer policy changes β€” Medicare LCD / NCD updates, commercial payer pre-auth expansions, telehealth code changes.
  • βœ—HIPAA violations β€” sharing PHI with the wrong caller, leaving screens unlocked, emailing PHI over unencrypted channels. Fireable at every practice and legally exposes the employer.

Salary Negotiation Levers

  • βœ“AAPC CPB or AMBA CMRS certification adds $3-8k to base salary immediately at most employers.
  • βœ“Specialty billing (surgery, oncology, radiology, DME, ASC) pays 10-15% more than family medicine or urgent care because CPT / modifier complexity is higher.
  • βœ“Hospital-based revenue cycle (HCA, Ascension, Kaiser, hospital-owned Epic Resolute shops) pays 15-20% more than independent physician office + full benefits.
  • βœ“RCM outsourcing companies (Optum360, R1 RCM, Change Healthcare / Conifer, Ensemble Health Partners) pay 10-20% above hospital direct β€” but production-metric intensive.
  • βœ“Law firm billing coordinators at BigLaw (Kirkland, Latham, Cravath, Skadden, White & Case) pay 20-40% above medical billing + strong benefits + bonus β€” LEDES / e-billing / OCG fluency is the differentiator.
  • βœ“Remote work is standard in medical billing post-2020 β€” 60-80% of RCM jobs are remote-first. Trade metro premium for remote flexibility, or negotiate a base-only comp if remote.
  • βœ“Bilingual (Spanish + English) adds $1-3/hr in most metros for patient-facing billing calls.
  • βœ“Coding cross-training (CPC β€” Certified Professional Coder) opens the biller β†’ coder path at $58-72k, a step above billing.

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Billing and Posting Clerks Salary by State

Best Cities (cost-adjusted) β†’

Salary Map β€” Click a state for details

$39K
$64Kβ–  No data

Top Paying States

District of Columbia
$64K
+33%
California
$56K
+16%
Massachusetts
$56K
+16%
Washington
$56K
+16%
Minnesota
$56K
+15%
New York
$53K
+10%
Rhode Island
$53K
+9%
Colorado
$53K
+9%
Maryland
$52K
+8%
Alaska
$52K
+8%
Vertical line = national median. Click a state for full details.
StateMedianvs. National
District of Columbia$64,330+32.6%
California$56,260+16.0%
Massachusetts$56,110+15.7%
Washington$56,090+15.6%
Minnesota$55,810+15.1%
New York$53,320+9.9%
Rhode Island$52,910+9.1%
Colorado$52,670+8.6%
Maryland$52,210+7.6%
Alaska$52,170+7.6%
1–10 of 51

Billing and Posting Clerks Salary by Metro Area

Metro AreaMedianvs. National
San Jose-Sunnyvale-Santa Clara, CA$70,280+44.9%
Rochester, MN$67,390+38.9%
San Francisco-Oakland-Fremont, CA$66,390+36.9%
New Haven, CT$61,180+26.1%
Napa, CA$59,810+23.3%
Seattle-Tacoma-Bellevue, WA$58,920+21.5%
Santa Cruz-Watsonville, CA$58,400+20.4%
Santa Rosa-Petaluma, CA$58,350+20.3%
Oxnard-Thousand Oaks-Ventura, CA$58,250+20.1%
Denver-Aurora-Centennial, CO$58,240+20.1%
1–10 of 392
Data Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS). Data reflects the most recent annual survey.
How does this compare to pro athletes?
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View Billing and Posting Clerks salary trend (2011–2024) β†’