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What Does a Medical Biller Do?

Do you want to work on the front lines of healthcare but not ready to work directly with patients? One option for helping patients without dealing with the clinical duties that comes along with most roles at a physician’s practice is to become a medical biller. You take on the administrative duties giving the medical assistants, nurses and doctors more time to take care of patient concerns.

What Does a Medical Biller Do?

A medical biller is the backbone of any physician’s office. Medical billers organize, manage, and code health information data, according to the U.S. Bureau of Labor Statistics. Medical billers may do the following:

  • Review patients’ records for timeliness, completeness, and accuracy
  • Submit insurance claims, get preauthorization and appeal rejected claims
  • Contact and answer question from patients
  • Organize and update information in electronic databases or registries
  • Use classification systems to assign clinical codes
  • Electronically record data for collection, storage, analysis, retrieval, and reporting
  • Adhere to HIPPA Guidelines and maintain confidentiality of patients’ records

Submitting Insurance Claims

Part of the job of a medical biller is submitting insurance claims for services rendered to patients. Whether it is private insurance or government insurance like Medicare, a medical biller will be tasked with submitting insurance claims for services rendered. This takes knowledge of medical codes and terminology that will be learned during a medical billing diploma program.

Appealing Rejected Claims

Sometimes claims are rejected for various reasons. Whether the wrong code is used, or a signature is missing, the job of a medical biller is to reconcile rejected claims and make sure they are properly approved. Rejected claims can negatively impact both the patient and office.

Obtaining Preauthorization for Services

So that claims are not rejected after the fact, many insurance companies require the medical biller to obtain preauthorization for services. This can be a hassle for physician’s practices but will stop that unexpected bill from going to the patient and ensure that the physician’s office is paid for services.

Medical Coding

The codes that medical offices use are invaluable to everyone involved. Many terms may sound alike but using the right medical code can reduce the number of medical errors and rejected claims. The following medical codes are used throughout a medical biller’s role:

ICD-10 – an abbreviation for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Used by healthcare systems worldwide, it classifies every symptom, injury or condition known to the scientific community.

CPT – Common Procedural Codes, are five-digit numbers classifying medical, surgical, and diagnostic procedures. Developed by the American Medical Association (AMA), they’re used on claim forms and to report medical outcomes to watchdog agencies.

HCPCS – Healthcare Common Procedure Coding System, is an alphanumeric coding system developed specifically for Medicare. It consists of three levels. Level I is the CPT index. Level II categorizes medical equipment, certain drugs, and ancillary services. Level III codes cover services or procedures not listed in levels I or II.

Do You Need a Diploma to Become a Medical biller?

Although you don’t technically need a diploma to become a medical biller, it does limit what you are able to do in a physician’s office. Some employers will only look to hire a fully trained medical biller because of the liabilities that are involved with the medical profession. From HIPPA guidelines to malpractice, a physician’s office may only hire medical billers with proven training and experience, so they don’t have to worry as much about the penalties of medical errors.

Benefits of a Vocational School Medical Billing Program

There are many benefits to attending a medical billing program from a vocational school. From a quick start to a flexible schedule, and everything in between, with a diploma you are ready to start working as a medical biller with confidence and knowledge that will shine through.

Benefit #1: A Quick Start

The best part about the medical billing program is that you can complete it in as little as 3 months, attending full-time. The program only focuses on what you need to perform the role and nothing else. Start learning quick and then start earning.

Benefit #2: Flexible Schedules

This program in particular is offered during the evening. We offer you a flexible schedule because we know you may have other responsibilities that you may need to attend to. We want to prepare you for the workforce and your new career in the medical field, and medical billing is a great first step.

Benefit #3: Small Class Sizes

Don’t want to be lost in a sea of students in a lecture hall? We offer small class sizes so you can receive more attention from industry experienced instructors. Whether you have a question, need guidance, or want to learn about a unique aspect of medical billing, our small classes allow you to talk with instructors and classmates alike. These small classes even lend themselves to networking that can be beneficial after graduation. Never know when you or someone you know will need a job in the medical industry.

Benefit #4: Career Services

Another great reason to attend a vocational school is the career services that we offer to graduates. From resume building, interview prep and job fairs, to job matching and community support. Our career services department will take the time to match you with a job that fits your skill level and expertise. We may even hear about some local job openings before the public, so you are sure to find a great fit to your passion.

Final Thoughts

It takes just 3 months to complete the Medical Billing Specialist program. It is a small investment of time, which can offer big benefits. Especially, when it is time to apply for a medical biller job. This diploma will open more opportunities throughout your career. Investing in yourself is the best investment you can make.

Did learning about what a medical biller does 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.