Medical billing has been an important activity for anyone in the healthcare business. With the creation of new regulations and policies regarding insurance companies, a medical biller needs to stay updated on any new bylaws regarding this matter.
Hiring a medical biller is vital to any healthcare company. Unfortunately, few people have the necessary skills to perform this job to its fullest, including coding. However, it is typical for companies to hire two prospects to perform these jobs separately.
Medical Biller Job Description
According to Wikipedia, medical billing is a payment practice within the United States health system. The process involves a healthcare provider obtaining insurance information from a patient, filing a claim, following up on, and appealing claims with health insurance companies in order to receive payment for services rendered, such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government-sponsored programs.
This definition means that medical billers are responsible for submitting claims to insurance companies through a process called revenue cycle management. If you would like to know more about this process, you can visit this article here. The article will help you understand the function of revenue cycle management and how medical billers perform their jobs.
10 Medical Biller Tasks
Below, you will find ten medical biller tasks that can help your company maintain its finances and claims in check. It is essential to mention that the main activity of a medical biller is to make sure that providers and facilities receive their payments in time.
1. Communication with Insurance Providers
As most jobs related to healthcare, one of the most important tasks of a medical biller is to communicate with insurance companies. They must follow medical testing procedures and inform insurance companies and healthcare providers about the patient's treatment.
2. Communication with Patients
Medical billers need to inform insurance companies about the medical procedures a patient will follow. They must also communicate with patients to get reimbursement for remaining costs uncovered by insurance providers.
While most medical billers do not possess coding abilities, the ones that do have an important job. Medical coders are responsible for reviewing medical documents and transforming the treatments into codes to ensure the proper payment process from the insurance company and the patient.
4. Code Review
Following the step above, medical billers must review these codes and claims to ensure their accuracy and that the codes represent the level of healthcare provided to the patient. This is one of the most critical medical biller tasks, as it represents the most amount of risk.
5. Reimbursement Claims
Medical billers use the diagnosis doctors provide and compare it to the results the medical coder passed on to them. With this comparison, they are able to create and submit reimbursement claims to the patient.
6. Internal Communication
Medical billers, medical coders, and doctors need effective communication between them. Effective communication between these three parties is required in case the medical biller finds any discrepancies or errors in the diagnosis, the treatment, the code, and the final costs of any procedure.
7. All-around Job
Medical billing is a complete job. While most enterprises have several positions for their healthcare department, most small businesses and medium-sized companies only have one person to do all of the medical biller and coder tasks. Even though this is hard to find, it can save you money instead of hiring various prospects. Medical billers can work in hospitals, clinics, healthcare centers, and long-term care facilities. Making them essential to any healthcare company.
8. Medical credentials
Most medical billers have medical credentials to back up their expertise through several fields. Although this is a requirement for most hospitals, if you can find a medical biller with a certification that fits into the type of healthcare you provide, chances are your business will start to see some differences in insurance charges as they are experts dealing with specific medical branches.
9. Insurance Company Knowledge
Every day, insurance companies are created to help people get the healthcare they deserve at the lowest prices. Medical billers need to keep up with new insurance companies and inform themselves about the different health plans they provide. In contrast, these professionals are experts in common insurance organizations such as Medicare, Medicaid, Blue Cross, Blue Shield, Tricare, etc.
10. Tech Savy
The last task we will look at is not technically a task, but it can definitely help your healthcare company. Medical billers are essentially bookkeepers. They can help with your business' finances. Following the lines of a bookkeeper, medical billers are experts in medical billing and accounting software. They have the ability to detect any discrepancies between patients, insurance providers, and medical coders and resolve them in a timely manner.
As you can see from this post, medical billing is a complete profession. Unfortunately, hiring a new medical biller that also does coding is expensive. Since it is a thorough job, their salary is relatively high. Here at New Age Cubicle, we want you to save the most amount of money instead of hiring a new worker and save you time if you decide to do this task by yourself.
Instead of hiring a physical medical biller, you may want to get a virtual one who can work remotely. Virtual medical billers also help automate specific tasks and make them, so you don't have to do everything yourself. You can also focus on more important tasks, like getting more clients or designing marketing campaigns to expand your business, while a virtual medical biller handles your insurance claims.
Join the future and try a virtual assistant today!