Medical Billers maintain patients’ payment records, receive and process payments, collect past due accounts and manage insurance claims.
They are generally focused on the business and financial aspect of healthcare services. They make sure that hospitals and physicians who have rendered their services are paid by patients.
Nature of Work
Medical billers can be found working in hospitals, insurance companies, medical clinics, healthcare facilities, private doctors’ offices, as well as third-party billing and collection agencies. Their primary function is to collect payment from patients for medical services they have received. They are responsible for compiling and tracking balances owed by patients to medical facilities such as medical clinics and medical offices. They are involved in making payment arrangements with patients and collecting on delinquent accounts. They take charge of organizing medical bills and statements, examining and checking them for errors, and negotiating with collection agencies when necessary. They review all charge slips and monitor payments, as well as analyze patients’ records in order to generate customized reports and pinpoint where profits are made and where improvements can be implemented. They are also tasked with answering questions from patients regarding their health-care plans and explaining to them the billing cycle of the medical facility. Medical billers can also work as medical coders who assign codes to procedures and diagnoses which are used to determine the amount of insurance payments. They prepare invoices, coordinate with doctors and insurance companies, and help patients resolve their complaints about billing, if any. Medical billers may also write appeals for denied claims and perform audits, as well as reimburse patients for medical procedures that have been paid for by their insurance agencies. They may also have to work with lawyers on the estates of dead patients to resolve their unpaid bills.
Qualifications
Medical billers are required to have at least a high school diploma or GED. They must also complete a medical billing and coding program which they could get at junior colleges or vocational schools. They could also take online courses for medical billing. However, most employers prefer those who have associate’s degree in medical billing or health information management. Those who want to become medical billers must have extensive knowledge of the steps involved in processing insurance claims, including Medicaid and Medicare regulations, Social Security disability rules, laws on debt and collection, and patient privacy laws and rights. They should also be knowledgeable on medical coding, medical terminology, and medical databases.