What Is The Job Description For a Medical Biller? Understanding The Profession

What is a Medical Biller?

A medical biller manages the billing insurance and payments for clients. They send claims to insurance companies for the issuance of payments. And talk to the clients if any payment is suspicious and fishy. 

The role of a medical biller is extremely important in the healthcare industry. Medical billers work as a face of the hospital. In other words, the frontmans. 

While understanding the job description for a medical biller, you must remember that this is a demanding job. As strong verbal and written communication skills are needed for striking conversations with the insurance companies, collection agencies, clients, patients, etc. 

Job Description For A Medical Biller

1. Billing and Coding

Medical coding means translating details from a patient’s medical document and transforming it into universal medical codes to accurately maintain and store medical records. The healthcare and pharmacy industry along with insurance companies use these standardized codes for record-keeping.

This is an important –and a key– responsibility included in the job description for a medical biller.

We also should not overlook the fact that an immense amount of attention and focus is needed to accurately perform this task. Along with most jobs associated with healthcare, this one also requires the presence of mind and cavernous focus.

2. Claims Processing

With these continuous dents in the world economy, the healthcare industry is getting more and more expensive with every passing day. To tackle these high costly bills many people are rushing to insurance companies for their medical emergencies. 

That’s where a claims processor comes into play. 

Claims processing is the process of looking over the insurance policies and contracts to determine if the policyholder can request for compensation.

And…that too is included in the job description for a medical biller. 

The claims process is a 6 steps procedure and below is how it looks like:

• Step 1: The biller files a claim either physically or digitally. And if it’s a hard copy, it has to be translated into a digital format.
• Step 2: The claim goes through the pair of eyes of the insurance carrier, where they ensure the claim looks good and is filed before the expiring period.
• Step 3: The insurance providers retrieve data from their database to verify their membership.
• Step 4: In this time taking and lengthy part of the process the insurance company checks the membership details. Figuring out if the subscriber’s insurance plan covers the services and benefits that they have applied for. They also check the percentage of cost-sharing that the member and their employer has to pay.
• Step 5: For this short step, the claim goes through a machine where the software flags suspicious claims for potential insurance deceit.
• Step 6: After checking the authenticity of the claim, the company issues the payment to the policy holder.

(Click here for a detailed read about the procedure.)

One must understand that the medical billers regularly go through one of the most painful things a human can experience, a rejection.

So, next time when you go to the hospital make sure to cheer them up by reminding them they’re doing absolutely well.

3. Record-keeping and Reporting

Another one of the most essential qualities in a job description for a medical biller is record-keeping and reporting. 

This one is pretty self-explanatory, but I must shed some light on how darn accurate you have to be to perform this repetitive task.

Sometimes, a patient’s life can depend on their medical record. They could be given the wrong medicine if the records are flawed and not accurate. Which can be extremely horrifying for the patient’s health as well as the institution’s reputation.

That’s why it’s essential for the organization to be able to retrieve any kind of data, anywhere, and at any time. And a medical biller makes that possible.

Accurately and organized data storage ensures the ease of access to specific pieces of information in the vast database.

Required Skills and Qualities

Understanding the key responsibilities, these are the required set of skills and abilities that a person must possess to be able to handle the force of being a medical biller:

Technical Skills

In this digital era, surviving without technical skills is nearly impossible. Every white collar job requires a basic or advanced level of technical skills. And medical billing is no different.

If you’re about to get a medical billing job, or if you’ve already secured one,—congrats in that case— be sure to polish your technical skills before showing up to your workplace.

Communication Skills

As we talked before, a medical biller must be a great communicator. Since they are responsible for talking to insurance companies, collection agencies, and patients. 

Improving one’s communication skills can be beneficial regardless of the profession but it is not a choice but a necessity for billers because they also have to explain billing information to patients in a comprehensive way. Simply put, in a way a normal person’s brain can comprehend. 

Time Management and Organization

A medical biller is juggling through tasks the entire day. As we just saw, numerous things are included in the job description for a medical biller. And to efficiently perform every task, one has to hop from task to task in order to complete them in the given time.

It’s also highly important to learn to prioritize specific tasks and let go of others to meet the near approaching deadlines.

A Closer Look at the Life of a Medical Biller

In conclusion, medical billing is a demanding job that demands tons of skills and qualities to be able to perform the job amazingly. Apart from that, it is a very significant part of the healthcare department. We must encourage those, working tirelessly every day, filing cases, checking databases, interpreting codes, keeping records, and saving lives.

I hope this article helped you understand the job description for a medical biller, if it did, please let me know in the comments. 

Thank you so much for reading. I wish you a very nice day!

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