Are you a detail-oriented person who enjoys paperwork and working with numbers? A position as a Medical Biller may be right for you.
Medical Billers are responsible for the timely submission of medical claims to insurance companies and payers such as Medicaid and Medicare. It is a critical position because the financial security of health care providers depends on these actions, from single-physician practices to large medical centers and hospitals.
Medical Billers may work in physician’s offices, hospitals, nursing homes, or other health care facilities.
Typical Duties and Responsibilities
- Perform posting charges and completion of claims to payers on time
- Obtain referrals and pre-authorizations as required for procedures
- Check eligibility and benefits verification for treatments, hospitalizations, and procedures
- Review patient bills for accuracy and completeness, and obtain any missing information
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
- Follow up on unpaid claims within a standard billing cycle timeframe
- Check each insurance payment for accuracy and compliance with contract discount
- Call insurance companies regarding any discrepancy in payments, if necessary
- Identify and bill secondary or tertiary insurances
- Review accounts for insurance or patient follow-up
- Research and appeal denied claims
- Answer all patient or insurance telephone inquiries on assigned accounts
- Set up patient payment plans and work collection accounts
- Update billing software with rate changes
- Update cash spreadsheets, and run collection reports
Education and Background
An associate degree is required for this position, preferably with an emphasis in business administration, accounting, or health care administration. A minimum of one to three years of experience in a medical office setting is preferred, as is an AAPC (American Academy of Professional Coders) medical billing certification.
Skills and Competencies
- Strong knowledge of Microsoft Access
- Close attention to detail
- Proficiency with electronic medical records
- Ability to multitask and meet tight deadlines
- Excellent problem-solving skills
- Ability to manage time with little supervision
- Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Expertise in the electronic and paper systems used in billing health care systems
According to Payscale the median annual salary of a Medical Biller with
1 Year of Experience:
- Orlando, Florida: $33,000
- Tampa, Florida: $40,000
- Jacksonville, Florida: $33,000
- Miami, Florida: $31,000
- Atlanta, Georgia: $35,000
- Chicago, Illinois: $36,000
- Houston, Texas: $30,000
- Los Angeles, California: $38,000
- New York City, New York: $40,000
- Seattle, Washington: $41,000
- Overall: $37,000
5 Years of Experience:
- Orlando, Florida: $35,000
- Tampa, Florida: $45,000
- Jacksonville, Florida: $35,000
- Miami, Florida: $38,000
- Atlanta, Georgia: $37,000
- Chicago, Illinois: $39,000
- Houston, Texas: $34,000
- Los Angeles, California: $40,000
- New York City, New York: $43,000
- Seattle, Washington: $43,000
- Overall: $40,000
Similar Job Titles
- Medical Coder
- Medical Insurance Biller
- Billing Specialist
- Insurance Verifier
The career path for a Medical Biller starts by first earning an associate degree, preferably with an emphasis in business administration, accounting, or health care administration. Then specialized medical billing training is preferred, by earning the AAPC (American Academy of Professional Coders) medical billing certification.
The health care industry is increasing year after year. More people are accessing health care services, which creates a growing need for trained medical billing personnel.
One reason for this is the aging population in the United States. Older people typically need more health care than young people. As the oversized baby-boom generation ages, the demand for health care services increases.
Also boosting demand: the rising rate of obesity in the United States, as well as chronic diseases such as diabetes.
One trend in the medical billing field is in increasing customer satisfaction. Patients are demanding more empathy and understanding from health care providers’ billing departments. Another trend: the rise in artificial intelligence (AI). With the growth in patients on high-deductible health insurance plans, and the growing challenges for providers to accurately collect payments, there’s a giant opportunity gap that AI has the potential to fill. This development could negatively impact growth for the position of Medical Biller.
The job outlook for a Medical Biller (and similar positions) is good, with 11 percent job growth projected from 2018 to 2028, according to the U.S. Bureau of Labor Statistics.
Typical Work Hours
The work hours for a Medical Biller are typically from 9 a.m. to 5 p.m. Monday through Friday in an office setting.
Where You Can Find Jobs
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