What exactly does a medical biller do?
Medical billing specialists are the person who process and track a patient’s medical records, collect payment from the patient’s insurance company or payer, and reconcile all medical bills for a healthcare facility. In an industry with millions of different professionals, it can be hard to find the perfect match for your company. But don’t get overwhelmed! Help is here. This blog post will provide you with some ways to identify the best person for your company.
Medical billers are health information technicians who manage payments on patient balances and oversee insurance claims for a health care provider. These professionals can work for a variety of health care practices, including primary care facilities, clinics, hospitals and specialists. Some common responsibilities include:
Creating invoices based on filing codes assigned to medical procedures
Submitting claims to insurance companies electronically and via mail
Sending invoices to patients for remaining balances after insurance payouts
Communicating with insurance company representatives to track payments and confirm patient coverage information
Investigating denied claims and outstanding patient invoices to ensure the provider receives payment
Managing patient payments and updating information over the phone and in person
Balancing sent claims and payments received to accurately record the provider’s monthly and quarterly earnings.
Medical Biller Salary
The medical billing industry is a highly competitive one, and the pay ranges widely depending on where you work. The median annual wage for a medical biller in the United States is $37,650.
That’s not to say that there aren’t plenty of opportunities to make more than this figure. Medical billers are usually paid an hourly wage and they will also receive bonuses based on their productivity. If you have experience with confidential information, strong organizational skills, and good computer skills, then a career as a medical biller could be right up your alley!
Medical biller salaries depend on the employee’s level of education and experience, as well as their employer’s practice and location.
Common salary in the U.S.: $16.55 per hour
Some salaries range from $7.25 to $29.50 per hour.
Medical biller requirements
These health information professionals often need specific requirements to gain employment and pursue advancement opportunities:
Many employers require medical biller candidates to have some form of post-secondary education, such as completed coursework or certification in medical billing. Medical billing courses are often offered through community colleges or vocational schools.
Some employers may prefer an associate’s degree in health information technology, health care administration or a related field. Medical billers may also choose to pursue a bachelor’s degree in health care administration, business or another related field to gain a more well-rounded education and possibly increase their earning potential and advancement opportunities.
Post-secondary programs and associate’s degrees in health information technology and other related fields provide these professionals with the necessary knowledge of medical codes, terminology, insurance policies, health care information regulations and other foundational concepts. Some programs may offer training in using medical billing software, creating documentation and invoices, organizing and analyzing data with spreadsheet software and other computer literacy tasks related to the role.
This education can be often applied in the workplace where more training occurs, often under the supervision of a current medical biller or office manager. Newly hired medical billers may learn to use the medical billing software their employer prefers and the specific billing processes used by the practice. During their initial training, they may also become acquainted with the common needs of their employer’s patients and better understand the current status of outstanding claims and invoices.
Some employers may require certification to prove the skills and knowledge needed to become a professional medical biller, and candidates may choose to pursue certifications to further their education and document their expertise. The following certifications can help you secure employment, advance your career and possibly increase your earning potential:
Registered Health Information Technician (RHIT)
Endorsed by the American Health Information Management Association, this certification assesses a professional’s ability to accurately document patient claims and productively contribute to a practice’s financial organization. This certification requires candidates to have an associate’s degree in health information management and complete a 3.5-hour multiple-choice exam covering topics such as patient data analysis, health care record-keeping and compliance.
Certified Professional Biller (CPB)
Hosted by the American Academy of Professional Coders, this certification proves a biller’s proficiency in submitting claims within national health care regulations and an in-depth understanding of a variety of insurance plans, including government-funded and privately funded programs.
The CPB also tests a biller’s familiarity with nationally recognized numerical codes assigned to the variety of medical procedures. The certification requires that you pass a 200-question multiple-choice exam that covers coding, billing policies and compliance.
Here are some common skills and qualities that help these professionals on the job:
Medical billers use exceptional customer service skills to discuss patient accounts and payments, often addressing challenging or sensitive situations. They practice empathy and active listening to fully understand patients’ needs and to answer questions regarding claims.
These professionals must be able to accurately and thoroughly document patient procedures as claims and invoices, which requires attention to detail and organizational skills. Documents may be sent electronically and via mail, so the ability to properly receive, sort and file information is necessary to ensure efficiency.
Medical billers often use various software programs to create and submit claims as well as to organize patient data. They should be comfortable completing tasks on a computer and learning new software and electronic documentation processes that are increasingly common in the healthcare industry.
These professionals often have to navigate complex data and use critical thinking and problem-solving skills to find potential errors, understand claims and review patients’ financial histories.
Medical billers may need to perform basic calculations when balancing a patient’s account. Math skills can help these professionals quickly provide financial updates to patients and providers.
Due to the sensitivity of the information they work with, medical billers need a high level of discretion and must comply with federally mandated security protocols on healthcare information as designated by the Healthcare Insurance Portability and Accountability Act (HIPAA). These professionals must keep data secure when discussing information with patients, healthcare providers, billing colleagues and insurance representatives.
Medical biller work environment
These professionals typically work in an office environment, often in a department of a practice, clinic or another health care facility. Some medical billers may work for health care information management companies that provide contractors to handle their clients’ accounts. Depending on the needs of the practice or their employer, some medical billers may work in separate locations or remotely from home.
These settings often include the following characteristics:
Sitting for extended periods
Using computers, printers and other office equipment
Communicating over the phone and in-person with patients, practitioners and fellow billing professionals
How to become a medical biller
Here are the most common steps for pursuing this career path:
1. Pursue the necessary education.
These professionals can earn a high school diploma or GED (General Education Diploma) and complete medical billing coursework at a community college or vocational school, which often results in a post-secondary certification. Other professionals choose to earn an associate’s degree in health information technology or a related field or earn a bachelor’s degree. Consider your career goals and the type of employer you want to work for when selecting which type of education to pursue.
2. Consider certifications.
Some employers may prefer certifications like the RHIT or CPB to prove your experience and knowledge of HIPAA regulations, accepted medical billing processes and other necessary skills.
3. Gain entry-level experience.
While pursuing your education or certification, consider seeking an entry-level position in a medical office, such as a receptionist role, to build your professional network and practice your customer service skills when interacting with patients. After pursuing education and earning certification, apply for entry-level medical biller positions to start gaining on-the-job experience.
4. Consider furthering your education.
Medical billers with certification or an associate’s degree can pursue a bachelor’s degree to expand their education and possibly advance to a senior medical biller or other leadership position within the department. Some medical billers also choose to complete coursework and certify in medical coding to open their career to new responsibilities.
5. Update your resume.
Include your highest level of education, relevant work experience, skills and achievements on your resume. Search for open medical biller positions in your area, and apply with a cover letter tailored to each position by using keywords from the job description.
Medical biller job description example
Hartford Community Clinic is seeking an exceptional medical biller to join the billing and accounts department. The candidate must have an Associate of Health Information Technology or a degree in a related field in addition to medical billing certification. The qualified candidate has three years of experience handling patient accounts and should be comfortable interacting with patients daily, communicating with insurance companies to track unpaid claims and be able to discreetly handle patient data per HIPAA requirements.