Launching a new career is always challenging, but it’s easier when you have support. The healthcare field is growing, and qualified medical billing specialists are in demand. But what exactly does a medical biller do? Is a billing career a good fit for you, and who can help you get started? We’ll show you the ropes.
What Does a Medical Biller Do?
Medical billers, also called billing and coding specialists, manage insurance claims and other billing responsibilities in healthcare settings. It’s a non-clinical role. On an average day, a medical biller:
Completes Insurance Claims
Most medical bills in the US are covered by insurance, but each policy is different and may or may not cover all services. The purpose of a claim form is to give the insurer the information necessary to determine if a patient’s policy covers the services they received. As a medical billing specialist, you’ll research the chart for data, complete the form and submit it for reimbursement.
A single medical bill may have two, three and even four payers. Each bears a portion of the financial responsibility based on what other payers cover, so tracking payments is critical. Medical billers ensure accounts reflect discounts and payments made by insurers before sending patients a bill for the balance.
Troubleshoots Rejected Claims
Some claims are initially denied because of coding errors or lack of data. Medical billers follow up on rejected claims, working directly with companies and patients to speed up reimbursement. Healthcare facilities depend on revenue from claims, so quick resolutions are essential.
Requests Insurance Preapprovals
Policy coverage can be a gray area. Services may be covered for one reason but not another, so requesting approval in advance is becoming the norm.
The process is similar to submitting claims. Medical billing specialists call the insurer or relay requests electronically on the patient’s behalf. Once approved, doctors know they’ll get paid, and patients won’t be surprised with an unexpected bill.
Medical billing specialists perform a range of financial functions in medical offices from accepting cash copayments and reconciling credit card receipts to collections and assisting patients with payment plans. If dollars and cents change hands, medical billing specialists are usually involved.
How Do I Start a Career in Medical Billing?
One of the fastest ways to start a career in medical billing is to get a vocational school diploma. It takes months, not years to graduate, but the education is still comprehensive, and the soft skills you’ll learn will serve you well in the workplace and beyond.
What Do I Learn in a Medical Billing and Coding Program?
Vocational school medical billing programs will prepare you with the skills necessary to succeed in an entry-level position and have fun doing it. The curriculum typically includes:
Pulling data from charts is a large part of what medical billing and coding specialists do, so having a working knowledge of healthcare jargon is essential. The terminology course introduces students to the common terms used to describe symptoms and conditions.
Instead of memorizing medical words, you’ll learn to decipher what terms mean by breaking them down into their parts. By the end of the course, you’ll be ready for anatomy and physiology.
Anatomy and Physiology
Anatomy and physiology courses for medical billers cover the 14 body systems, associated conditions and treatments. Less intense than what clinical providers learn, it’s an entry-level class that doesn’t require a background in chemistry or biology. The goal is to familiarize you with how the body works, so you’ll be comfortable researching doctor’s notes and surgical reports.
Billing and Coding Practices
Medical billers code insurance forms with alphanumeric shorthand designed to reduce the total volume of data changing hands. This course covers the three most common coding systems and how they’re used in the medical billing process. They include ICD-10, CPT & HCPCS.
You’ll also learn more about billing procedures, including patients’ rights, provider responsibilities and ethical considerations. Other topics include government insurance plans, commercial policies, reimbursement principles and fraud detection.
Most medical billing is digital, so students need a solid foundation in internet applications. In this course, you’ll learn how to access, copy, share and store files between and within programs. Other topics include e-mail, cloud storage, and computer security. This course readies you for more intensive computer applications.
Electronic Medical Records
Electronic medical records are compilations of patients’ health and financial data. They’re similar to paper charts except that they’re computerized for easy accessibility. This course teaches you how to find data and update accounts.
Microsoft Office is a suite of desktop productivity software. It includes six programs, a word processor, spreadsheet, and presentation creator. It’s everything you need to draft correspondence, track data and communicate electronically. Compatible with most practice management software, it’s the gateway for most office functions.
Healthcare facilities have seen a large increase in data growth in the past few years. Most of it is stored in databases, the digital equivalent of filing cabinets. Whether it’s health or financial data, information is only meaningful if it’s accessible. Medical billers learn to retrieve and properly store this documentation.
Communication and Human Relations
Healthcare is a people-centered industry, so good communication skills are vital. Medical billers work with patients daily to resolve billing issues. In this class, you’ll learn about the importance of customer service and how to deliver a good experience. Other topics include interpersonal communication, problem-solving strategies, and workplace relationship development.
Computerized Accounting with QuickBooks
QuickBooks is America’s premier all-in-one accounting program for small businesses. Used by private practices for light bookkeeping, payroll and inventory management, it simplifies the accounting process by tracking assets, liabilities, revenue and expenses. Once data is entered into the system, it can be used to perform a wide range of tasks from payment tracking to collections.
What Are the Benefits of Attending a Medical Billing Program?
Beginning a new career is tough if you don’t have the right skills or know anyone in the business, but vocational schools are there to lend a hand. Program benefits include:
A Quicker Start
Most jobs in the medical field require a college degree, but not medical billing. Full-time students can graduate with a diploma in as little as 3 months. If you’re ready for a career change but have responsibilities and can’t afford to spend years in college, a vocational school prepares you in a fraction of the time.
A Complete Curriculum
Vocational school diploma programs are shorter than degree programs, but it’s not because they cut corners. They eliminate elective courses that don’t contribute to your skills as a medical biller, focusing on the practical aspects of education. And the curriculum is equally comprehensive, it’s a shorter path, not a shortcut.
A Competitive Advantage
Medical billers are in demand, but employers want qualified candidates with proven skills. They know that vocational school graduates are well-trained and committed to the field. When you’re competing for jobs with experienced applicants, having a diploma stands out.
College professors are experts in their field, but they may have little or no real-world experience in your chosen occupation. On the other hand, vocational schools hire industry-seasoned faculty, so students benefit from their experience. You’ll learn the ropes from someone who can offer valuable, practical advice that bridges the gap between the classroom and the workplace.
Becoming a certified medical billing specialist is a faster way to advance in the field. Vocational schools may help prepare you for various certifications, bringing you a step closer to your professional goals.
All education is meaningful, but it doesn’t always translate into employment opportunities. Instead of searching help wanted ads, students can work with career counselors in their search. It’s one more value-added benefit that comes with a diploma.
Where Do Medical Billing Specialists Work?
Medical billing and coding specialists can work anywhere healthcare bills are created or processed, such as:
Private Practices and Labs
Doctors hire medical billing specialists to manage accounting and insurance claims. You’ll be part of a small team that tracks transactions from start to finish. It’s a fast-paced but flexible environment where you can try your hand at all aspects of billing.
If your training includes hospital billing, that is another environment filled with opportunity.
Hospitals employ medical billing specialists for many roles. As part of a large team, your job may be limited to certain types of tasks.
You may, for example, handle only insurance claims or collection cases. But you can gain experience and cultivate new skills by moving through different departments. If you prefer to be a specialist versus a jack-of-all-trades, working in a hospital is a good place to start.
Medical Billing Services
Some practices and facilities are outsourcing their billing needs to independent agencies. Working for a billing service, you’ll manage accounts for multiple providers. If you prefer billing over coding, this is the setting for you.
Are you interested in a career in medical billing? Have a knack for billing and coding? Why be stuck in reverse when you can turn your aptitude for finance and passion for healthcare into a secure and rewarding career? Learn more about Hunter Business School’s medical biller program and start moving forward in your career today.
Did learning about how long medical coding school takes interest you? The Medical biller 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 physician’s offices. The Medical biller program is a 3-month diploma program available in the evening.
Contact us today to find out more on how to become a medical biller on Long Island.