Because healthcare and health insurance are probably two of the most complicated areas of modern commerce, it's not that surprising that medical billing, where those two intersect, is also very complex. In the distant past, physicians and other healthcare providers managed their own billing. In the recent past, medical billing specialists typically had only a high school diploma, and received the rest of their training on the job. It is now essential that medical billing specialists have specific training in their field, and complete periodic continuing education as well, in order to stay current on the legal and technological developments in medical billing.