Medical Biller Career Profile

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Medical billers are responsible for the timely submission of technical or professional medical claims to insurance companies including physician offices, hospitals, nursing homes, or other healthcare facilities. In a hospital setting, medical billers perform different functions than medical billers that work in a physician's office, home health, clinic, or other healthcare facilities.

Hospital medical billers typically stick to duties that revolve around processing medical claims for payment. Medical billers that work in other types of medical offices may also be responsible for medical billing, coding, and charge entry.

Medical billers are also referred to as:

  • Hospital billers
  • Accounts receivable billers
  • Billing and coding specialists
  • Medical biller and collectors
  • Patient account representatives
  • Billing specialists

Salary Expectations

A medical biller can expect to earn a salary ranging from $25,000 to over $60,000 per year. The average salary per year is around $25,000 per year. The salary is contingent upon a number of variables such as location, size of facility, hours, incentives, education, experience, and other factors.

The job forecast for medical biller is excellent. The growth rate for this career is expected to be at or around 30% over the next 10 years due to continued growth in the healthcare industry. Opportunities are expected to increase in all medical and healthcare facilities.

Nature of the Work

Medical billers have a wide range of job duties that include but are not limited to the following:

  • Review patient bills for accuracy and completeness and obtain any missing information
  • Knowledge of insurance guidelines especially Medicare and state Medicaid
  • Follow up on unpaid claims within standard billing cycle timeframe
  • Check each insurance payment is for accuracy and compliance with contract discount
  • Call insurance companies regarding any discrepancy in payments if necessary
  • Identify and bill secondary or tertiary insurances
  • All accounts are to be reviewed for insurance or patient follow-up
  • Answer all patient or insurance telephone inquiries pertaining to assigned accounts.

Position Requirements

Most medical billers only require a high school diploma or an associates degree. Some medical offices may require medical billers to have the knowledge of business and accounting processes usually obtained from an Associates in Business Administration, Accounting or Health Care Administration preferred.

Some medical offices may require a certification in medical billing which can be obtained through a number of healthcare associations. Medical offices may also require that a candidate have a minimum of 1 to 3 years in a medical office setting.

Working in the Medical Office

Some of the physical and mental characteristics of a successful medical biller will include the following:

  • Critical thinking skills
  • Detail-oriented
  • Time management skills
  • Organizational Skills
  • Ability to handle stressful situations
  • Ability to communicate effectively
  • Computer skills

A Must Read

A medical office handles the administrative tasks for a medical practice, hospital, or other medical facility including greeting patients, scheduling appointments, check-in and registration, collect money, and a number of other tasks including medical billing. While most of the other tasks performed by the medical office are the same across all medical facility types, medical billing is not.

If you ask most medical billers, they will tell you there are significant differences in the processing of medical claims across different specialties and facility types. There is an absolute difference in billing between healthcare and other industries. In medical billing, there are two different types of billing — professional billing and institutional billing.

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