Careers in the medical field are not only rewarding, they’re exceptionally diverse. Health care is a burgeoning industry, and for every doctor and nurse on the job, there’s a need for trained support specialists behind the scenes to keep the business end of things running smoothly.
Hands-on medicine isn’t for everyone, but for students with interest in both health and business, a career as a medical biller could be just what the doctor ordered.
What Does a Medical Biller Do?
Medical billers work in hospitals and physicians’ offices. They collect and enter the data necessary to prepare insurance claims and bill patients. Without them, doctors and facilities wouldn’t get paid.
More than ninety percent of the cost of health care in the United States is shared by patients and insurance companies, so the billing process can be complicated. A medical biller’s responsibilities include these tasks.
- Entering demographic and insurance data into a claims database
- Analyzing medical information and transcribing it into standardized billing codes
- Obtaining insurance preapproval for medical services
- Researching, correcting, and resubmitting rejected claims
- Preparing claims appeals
- Posting payments
- Billing patients for insurance copayments or non-covered services
- Answering client questions about insurance, billing, and payments
- Helping uninsured patients to apply for financial assistance or to set up a payment plan
- Assisting with collections, as needed
Positions in a front office may also require doing general administrative tasks, such as answering the phone and checking patients in for appointments.
Back office positions may be more financially focused and could include additional duties, such as running financial reports and balancing cash collections.
Skills for Success as a Medical Biller
With the right training program, anyone can succeed as a medical biller, but it’s helpful to have these personal qualities and practical skills.
Today, most information between providers and insurance companies is exchanged online. Medical practice management and claims software take the sting out of filling out paper forms, but that means medical billers will spend most of their day at a computer.
The role is data-heavy and requires managing multiple applications at the same time. Keyboarding skills and working knowledge of computer technology make the job easier.
Basic Math Aptitude
Medical billers work with numbers constantly. The claims software does most of the math, but understanding issues with its conclusions requires comfort with basic arithmetic. There are no fancy theorems to remember, just addition, subtraction, multiplication, and division.
Medical billers are often patients’ point of contact for questions about charges and what insurance companies cover. Since medical bills are often shared between insurers and patients by percentage, brushing up on estimates, fractions, and decimals helps.
Health care is a people industry, even in an office setting. Medical billers communicate with others daily by phone or via email to discuss accounts, handle payments, and troubleshoot problems, so the ability to speak and write confidently and professionally is a must. Medical billers should be comfortable interacting with patients and expressing themselves to clinical staff and insurance representatives.
Attention to Detail
Standardized alphanumeric billing codes are a form of financial shorthand. They help convey a large amount of information about a patient and the health care services they received with just a few letters and numbers.
There are, however, several coding systems and tens of thousands of codes that classify diagnoses, treatments, and medical supplies into reimbursable categories. It takes focus and a keen eye for detail to find the right ones.
Some medical claims submitted have errors in demographic information or coding, leading to delays in payment. A medical practice’s cash flow depends on the medical biller’s accuracy and efficiency.
Problem Solving Expertise
Medical billers are problem solvers. Most of the time claims forms are submitted and paid without issue. The rest of the time, however, they run into roadblocks.
A medical biller can expect to spend at least part of most days troubleshooting rejected claims, correcting billing errors, and helping patients understand charges. This part of the job can be either frustrating or satisfying, depending on how someone views problem solving challenges.
The world of medical billing is fast-paced. Cash flow depends on prompt payments, which in turn relies on quick and accurate billing. On any given day, medical billers must balance lists of claims to be submitted while keeping tabs on previously submitted forms and correcting rejected claims.
A medical biller may also be involved in requesting insurance preapproval for services, a time sensitive task that usually can’t wait. It’s a lot to juggle, so being comfortable multitasking is a plus.
The Health Insurance Portability and Accountability Act of 1996, or HIPAA, strictly governs who can have access to a patient’s health information. As a doctor’s representative, a medical biller reviews countless medical records and has access to sensitive details about people’s lives.
Safeguarding that information and being responsible are not only ethical, but they’re also required by law. Violating HIPAA regulations can result in job loss for employees and hefty financial penalties for employers.
Doctors and nurses aren’t the only members of the health care team who are called upon to be compassionate. Health care is costly, and even patients with insurance may struggle to pay their bills.
Today’s larger medical offices often have medical billers dedicated to helping patients find financial means to pay for services. Working one-on-one with patients who are caught between needing care and making ends meet can be emotional. It takes compassion and empathy to do it successfully.
How to Become a Medical Biller
Anyone with clerical experience could land a job as a medical biller and get on-the-job training, but today, employers prefer to hire graduates of formal training programs.
Vocational schools offer a wide range of learning options from certificate programs to associate degrees. Students on the fast track can be out of the classroom and ready to work in less than a year. What do medical biller programs teach that make them so valuable?
Depending on the program, students may learn
- Medical terminology
- Health information management
- Basic accounting principles
- Diagnostic and procedural coding
- Insurance practices
- Health care law and ethics
- Practice management software
- Office administrative procedures
- Medical billing practices
Training programs also prepare graduates for certification. While becoming certified isn’t a requirement to work as a medical biller, it opens the door to greater opportunity. Health care providers are always looking for certified professionals who understand how billing and other financial issues affect their practices. And as health care becomes more complex, specialty certifications make job applicants even more attractive.
The career forecast for medical billers has never been brighter. The work is challenging, but it’s personally rewarding, and there’s plenty of room for professional growth. A new career in health care could be just months away, so why wait?
Did learning about how to become a medical biller interest you? Are you ready for a rewarding career as a medical biller?
The Medical Billing Specialist program at Hunter Business School on Long Island prepares billing and coding students to obtain entry-level employment specializing in medical related billing and coding in physicians’ offices, clinics, medical insurance companies, and hospitals.
The Medical Billing Specialist program is a three-month diploma program available in the evening.
Contact us today to find out more about how to become a medical biller on Long Island.