Difference Between a Dental Biller and Dental Coder
Published by the American Dental Coders Association
Understanding the distinction between a dental biller and a dental coder is essential for dental practices, job seekers, and anyone pursuing a career in dental administration. While the two roles often work closely together—and sometimes even overlap—they involve distinct responsibilities that require different skill sets, training, and certifications.
In this article, we’ll explore the roles, responsibilities, and required qualifications of both dental billers and dental coders, and explain how they complement each other to ensure the financial health of a dental practice.
What is a Dental Coder?
A dental coder is a professional responsible for accurately translating dental procedures into standardized codes. These codes are primarily drawn from the Current Dental Terminology (CDT) set, maintained by the American Dental Association.
Key Responsibilities of a Dental Coder:
Reviewing clinical documentation for accuracy and completeness
Assigning the correct CDT codes to treatments and procedures
Staying up to date with annual CDT code updates
Working with providers to clarify clinical notes if documentation is insufficient
Ensuring coding compliance with payer rules and ADA guidelines
Supporting audits or claims appeals with correct coding evidence
Skills Needed:
Deep knowledge of CDT codes and their usage
Attention to detail
Ability to interpret clinical and diagnostic records
Strong understanding of insurance plan guidelines
Familiarity with ICD-10 codes when cross-coding for medical billing
Certification Path:
To become a certified dental coder, professionals can take the Certified Dental Coder (CDC) exam offered by the American Dental Coders Association. This certification validates their expertise in dental procedure coding and compliance.
What is a Dental Biller?
A dental biller is responsible for the financial processing of dental claims. Their job focuses on preparing and submitting insurance claims, tracking payment status, and ensuring timely reimbursement.
Key Responsibilities of a Dental Biller:
Preparing insurance claims using CDT codes provided by the coder
Submitting claims electronically or by mail
Verifying patient eligibility and benefits
Posting payments and reconciling Explanation of Benefits (EOBs)
Following up on denied or delayed claims
Communicating with patients about their financial responsibility
Generating patient statements and managing accounts receivable
Skills Needed:
Knowledge of dental insurance plans and payer rules
Understanding of CDT codes and how to use them in billing software
Strong communication and customer service skills
Familiarity with EOBs, pre-authorizations, and appeals
Proficiency with billing software and clearinghouses
Certification Path:
The Certified Dental Billing Specialist (CDBS) certification is ideal for those looking to pursue or advance a career in dental billing. The American Dental Coders Association offers a comprehensive online class that awards 22 CEUs upon completion.
Side-by-Side Comparison
| Role | Dental Coder | Dental Biller |
|---|---|---|
| Focus | Assigning correct CDT (and ICD-10) codes | Submitting insurance claims and managing reimbursements |
| Primary Task | Reviewing and translating clinical notes into codes | Creating, submitting, and tracking claims and patient billing |
| Interaction | Works closely with the dentist and chart notes | Works with insurance companies and patients |
| Skills | Clinical understanding and code accuracy | Insurance rules, payment follow-up, and A/R |
| Training | CDT code training and compliance | Insurance claim processes, billing software |
| Certification | CDC Exam | CDBS Exam |
Can One Person Do Both?
In smaller dental practices, it’s common for one team member to handle both coding and billing. However, as practices grow or become more specialized, the need for dedicated roles becomes essential to minimize claim errors, reduce denials, and ensure compliance with payers.
Having specialized training in each area—through certifications like the CDC and CDBS—ensures accuracy, speed, and financial efficiency.
Why It Matters
Understanding the difference between a dental biller and coder helps:
Dentists hire the right professionals
Dental office managers delegate work correctly
Professionals choose the right career path
Practices reduce claim errors and denials
Patients experience smoother billing and insurance processes
Each role is vital. Without accurate coding, claims are denied. Without strong billing follow-up, payments are delayed. When both roles are performed well, dental practices thrive financially, and patients receive accurate billing.
Boost Your Career with Certification
If you’re considering a career in dental administration, take the next step by becoming certified:
Certified Dental Billing Specialist (CDBS): Earn 22 CEUs online and master the insurance and revenue side of dental care.
Certified Dental Coder (CDC): Earn 40 CEUs online and become an expert in dental procedure coding.
Both certifications are designed for flexible, online learning and include access to ADCA resources, exams, and continuing education credits.
Ask Questions, Get Support
Still unsure which path is right for you? Visit Ask-The-Coder, a free knowledge base where dental professionals can ask real-world coding and billing questions—answered by experts.
Join the ADCA Community
Whether you’re new to dental administration or looking to level up your skills, becoming an ADCA Member gives you access to industry resources, continuing education, and a professional network that supports your career growth.
