If you think you want to be a medical biller, then you have come to the right place! Continue reading for all of the information you will need to begin traveling down your dream career path as a medical biller. Start your training by finding a medical billing school that fits your schedule. It can often be difficult to obtain a job as a medical biller. This is mostly due to the fact that getting your foot in the door at a medical establishment and then working on your experience level as a medical biller seems to be the best approach. In fact, many medical facilities prefer medical billers that have significant field experience as opposed to formal education.
Before you decide to start working on your degree to become a medical biller, you may want to peruse the classified ads for available jobs in your area. You may find a job that will allow you to gain the desired experience, which will allow you to save your money for a more appropriate educational avenue.
However, keep in mind that if you do decide to pursue your degree as a medical biller your resume will definitely speak for itself! Your qualifications will enable you to stand out from other prospective job candidates. Find a medical billing class below to get either your degree or certification.
Should you decide to become a medical biller, perhaps the first thing you need to ensure is that you are extremely organized. Your level of organizational skills will either make you a very successful medical biller or can in turn be your demise in this profession. Do you wonder if being a medical biller will be interesting to you? Do you wonder what type of tasks you will be performing? First, to be a successful medical biller you will need to possess a basic knowledge of the medical billing process. This is where the previous work experience can definitely come in handy for you. As a medical biller, you will also need to learn the claims submission process, learn how to determine rejection reasons by reviewing specific insurance carrier codes, and learn to make the necessary adjustments based on the provided rejections.
At this point in the medical billing process, you will be in charge of posting any payments that are received. This will include making all provider contracted adjustments, which is determined by following specific insurance carrier guidelines. As part of the medical billing process, you will be responsible for reporting a patient's denied charges to the coding specialist in your department. It is extremely crucial that as a medical biller you keep very detailed notes and logs of your conversations and work for each patient file. This will enable any personnel working on a particular patient's file to pick up exactly where you left off in the billing process, or to later follow your method of billing.
Often, individuals who work as a medical biller are also qualified to be a medical coder or a medical transcriptionist. While these three occupations are not exactly the same, the background knowledge for each of them somewhat overlap. Thus, the work conducted by each profession somewhat overlaps into the next. In small medical facilities, an individual may find themselves handling more than one of these occupations. All of the medical billing schools below could be the perfect fit for your career training. Be sure to see if they have financial aid available.
Medical billing is a great career and you’ll cover a lot of different topics during your certificate or diploma training. Below are just some of the areas you’ll cover
- Healthcare Industry: You’ll learn to understand how the entire healthcare industry works and the role that a medical biller plays. Your course will cover how medical offices get reimbursed by insurance companies and the tasks you’ll take in order for the doctor’s office you work for to get paid.
- Privacy: With the introduction of HIPPA you’ll understand the rights of patients as well as the provider. You’ll view case study work regarding criminal litigation and even learn about the different malpractice lawsuits associated with your new industry. Privacy laws are constantly changing and you’ll need to stay on top of this area with ongoing training typically done at your new employment.
- Medical Billing Process: As a medical biller you’ll need to understand the different processes needed including how payments are and fees are distributed. These complex methodologies will help you during the payment process.
- Medical Terminology: Although this isn’t a medical terminology course you’ll need to be familiar with the language that everyone uses in the industry. You’ll learn about root words as well as the different types of anatomy including the musculoskeletal system.
With the right medical billing training you’ll be on your way to finding employment at a variety of employers including:
1. Doctor’s Offices: Every doctor’s office needs to employ those who handle insurance companies and payment. It is common that the role of a medical biller is done by the front office assistant. By having already taken a training course you’ll have an advantage over other candidates looking for this entry level position.
2. Insurance Companies: Most would think that medical billers only work on the healthcare side of the industry but trained medical billers are also needed on the insurance side. They are the ones that work with doctor’s offices in order to process their payments and insurance claims. You’ll need to be trained on the same procedures as a medical biller.
3. Hospitals and Nursing Homes: Like with a doctor’s office the need for medical billers is the same but only amplified due to the number of patients. At a hospital you might be working with a team of medical billers that handle the entire process for the facility.
When reviewing the schools listed the one thing to be sure of is that they have created their training program on industry medical billing and coding standards. The AAPC (American Academy of Professional Coders) offers certifications for medical billers and coders. CPC, CPC-H and CPC-P are all certifications you can earn. Because it is not necessary to earn a license to become a medical biller you need to realize that it will be very hard to get hired without the proper training. It is recommended that you take these exams offered.
How Medical Billers Can Bring Best Practices To Work
As a medical biller, your job will involve more than a regular routine of bill, collect, and repeat. There will be certain steps in the medical billing process that you can count on performing, such as:
1. Entering patient information in an electronic health records software program.
2. Entering CPT and ICD-9 codes into the patient’s record.
3. Transmit claims electronically to insurance providers.
4. Receive audit reports, correct errors and resubmit rejected claims.
5. Post patient account payments.
6. Review patient accounts to assess bills that have not been paid on time.
7. Call insurance providers to follow through on delinquent claims, if necessary.
8. Repeat all seven steps each day.
With time, your role as a medical biller will go above and beyond simply billing patients and collecting money from them. There will be better ways to perform medical billing, also known as best practices. It is the best practices of medical billing that can positively affect collecting money, improve coding accuracy and increase insurance claim approvals. But how should a medical biller approach best practices, determine what they are and start using them in their job?
Where do best practices come from?
Medical billers are hired by some of the busiest people around – physicians. They see patients, write up reports, stay on top of medical advances and also run a practice. Physicians who are dedicated to taking the best care possible of their patients need to also look at applying this dedication to taking care of their business. By having a medical billing professional to help them stay on top of ever-changing billing information, while also learning ways to help improve the medical billing process, physicians can be assured that best practices are being utilized for this very important part of their practice.
Saving money for your employer
It is always a good idea to review billing processes to see if changes can be made for improvement. If a new process saves money, while also improving efficiency and increasing productivity, it is a win-win for the medical biller and the practice. Once you have gone to work for a physician, try reviewing current medical billing procedures to see if improvements for coding and billing can be made. Doing so may help reduce the number of overdue bills and help you shine in your employer’s eyes.
If there are improvements that can be made, take them to your employer. Your feedback will help the physician see what has changed in the industry and how changes to the billing process can help improve cash flow, reduce billing time and improve claim acceptance to insurance providers. In turn, this helps your employer make informed decisions that can lead to better business choices and plans for the future. It also helps to build trust in you and your capabilities as a medical billing professional.
What should you be doing for best practices?
Here are a few things to focus on when you are going through the daily medical billing process. Asking yourself these questions can help you provide good feedback to your employer.
• Am I looking for ways to increase productivity and profitability?
• Am I looking at performance standards of staff, both in-office and outsourced?
• How often can I provide my employer with recommendations that will improve his/her processes?
• Will I help train his/her staff if any problems arise after I provide feedback?
A good medical billing professional will provide feedback on all of the above, as well as routinely review medical billing procedures to help improve billing, payments and recordkeeping. Most importantly, though, is that you know the unique needs of your employer. This will help you address issues with coding or insurance changes that should be implemented that increase productivity. By putting best practices in place with your medical billing experience, you can set yourself not only apart from competition for physicians’ billing, but make yourself an invaluable resource to help the practice continually improve.
Medical Billing Resources:
American Medical Billing Association - http://www.ambanet.net/
AAPC - https://www.aapc.com/
Healthcare Billing and Management Association - http://www.hbma.org/