A medical biller works in places like hospitals, doctors’ offices, insurance companies, nursing homes and ambulatory care centers. Your main responsibility is to process all medical bills from patient records.
Medical billing process
The medical billing process begins with the medical biller by entering the patient’s basic information, such as name, address, insurance company information and medical history, on a computer.
After the patient has visited a doctor and a diagnostic procedure has been determined, the medical biller will receive the patient’s information that contains two numeric codes. These codes represent the level of service given and the verbal diagnosis made. Your obligations are to check the patient’s insurance coverage and prepare and submit the claim to the insurance company. They can also file insurance claims, either on paper, by mail or electronically.
Medical billers work with patients and insurance companies to meet the obligations of the patient’s account. The insurance company will pay the claim or reject it. If the request is rejected, it must be reviewed and the issuer of the invoice must resubmit the claim or the doctor can accept an incomplete refund. Negotiations on the payment of a claim can take place between the doctor and the insurance company until the claim is paid in full.
The medical biller is responsible for collecting, processing and publishing all accounts receivable and managing the patient’s account. Accounts receivable include payments from insurance companies and payments made by the patient.
Medical billers assess the patient’s financial ability to pay pending payments not reimbursed by the insurance company and draw up any necessary payment plans. They also charge any amount owed and resolve the outstanding issues with some accounts. If an account is due, it may be the responsibility of calling the patient to collect it.
Other job functions of a medical biller are to answer questions that patients or insurance companies may have and resolve any issue or complaint.
To carry out services such as medical billing, you must have sufficient training in medical accounting, medical billing and coding, medical law, basic insurance and procedural terms. The medical biller must also be familiar with all the plans that the insurance companies carry, including all the fee programs.
It is essential to have computer knowledge, medical practice management software, basic office equipment and multifonic lines. The ability to perform basic office procedures and offer quality customer service are also important functions of a medical biller.