Medical Billing Work

Medical billing work is handled by medical billers at hospitals, nursing homes, physicians' offices, and other healthcare facilities. It is a process in which the healthcare providers submit claims to health insurance companies and follow up for the payments of the same. It is an important process since it helps the financial cycle of healthcare facilities move forward. After all, without payment or money, it will be difficult to provide healthcare services.

Medical billing work needs to be handled by trained and experienced professional since any mistakes could lengthen the claim settlement or payment collection. That's why healthcare employers seek candidates with a strong attention to details, good math skills, and ability to work with both paper and electronic systems for this job. It is the medical billers who process the claims and ensure payment within the set timeframe.

Medical Biller Job Description

If we have to sum up the medical biller job in one sentence, then it would be submitting and following up medical claims with insurance companies. However, the medical biller has to take care of lots of things before submitting the claims. He or she needs to collect medical documents of patients to whom the facility has provided services. To do this, the jobholder needs to coordinate with the respective department, verify charges, etc. The most important part of the job is to calculate charges for the services provided accurately.

Medical Biller Job Duties

The job duties of a medical biller will depend on the setting he or she is working in. If the facility receives a large number of patients with insurance, the workload will be more. However, regardless of the medical facility, daily tasks entailed in this job include:

• Checking insurance policies and identifying their completeness and validity
• Getting pre-authorizations for claim processing
• Checking eligibility and verifying benefits for hospitalization and treatments
• Collecting missing information and reviewing patients' bills for completeness and accuracy
• Using billing software for preparing, reviewing, and transmitting claims
• Communicating with insurance companies for payment collection and any discrepancy in payments
• Ensuring accuracy and completeness of insurance payments and verifying contract discount
• identifying and billing tertiary coverage
• Assisting patients in producing insurance information and filing up forms
• Clarifying doubts of patients and insurance companies about assigned accounts
• Setting and following up payment plans
• Staying abreast with the changes in treatment rates, and updating the same in billing software
• Drafting payment collected and pending reports, and submitting them to the higher authority
• Maintaining patient data right from the first visit to discharge as well as follow-ups
• Maintaining, preserving, and protecting patient data
• Communicating with physicians and assistants for clearing doubts on services and charges

Medical Biller Education and Experience

Though medical billing work needs experience, you can still get the job even with minimum experience if you can convince the employers that you're trained well to handle the job responsibilities efficiently. However, it will depend on the need of the employers and complexity of the job. Basic requirements for the job are:

• A high school diploma
• A bachelor's degree in Accounting, or Business Administration, or Health Care Administration
• Knowledge of accounting and billing procedures
• One to three years of experience in any medical setting

Medical Biller Knowledge, Skills and Abilities

A medical biller resume must showcase the knowledge, skills, and abilities that employers are expecting to read.

• Knowledge of Medicare, Medicaid, HMO/PPO, and claim procedures
• Computer skills and ability to work with latest medical billing software
• Basic knowledge of medical coding
• Excellent communication, interpersonal, and customer service skills
• Ability to answer patient queries and resolve payment discrepancy
• Ability to resolve issues in a professional manner and work in a face-paced environment
• Knowledge of medical terminology, accounting and bookkeeping procedures
• Familiarity with HIPAA
• Multi-tasking and strong research skills

Medical Biller Job Outlook

Job prospects for medical billers are likely to grow by 21% from 2017 to 2020. Since this job is associated with the most basic and essential needs of the people, this profession is always going to be demand.

If getting ready to apply for the job, take a moment to browse the medical biller resume samples provided on our site. The resume samples will definitely help you in obtaining your dream job.