What Does a Medical Biller Do?

What Does a Medical Biller Do?

By Manhattan Institute
Posted in Medical Billing and Coding
On September 16, 2015

Do you want to start a career in the medical field but don’t know where to start? There are so many job opportunities available in healthcare that finding the right one for you can be a challenge.

If you’re interested in the medical field but don’t want to take the nursing route, starting a job as a Medical Biller can get you the healthcare experience you need to pursue the career you want.

Not really sure what a Medical Biller does? Learn what a Medical Biller does in order to determine what type of medical billing and coding training you need and ultimately decide whether this is the right education and career move for you.

Medical Billing

Medical Billers are responsible for making sure that patients’ insurance files are up-to-date and that their insurance company receives the right information from the physician’s office. As a Medical Biller, you collect and record the patient’s personal information, including address, medical history, and insurance information.

Keeping these records accurate is extremely important to the smooth running of the physician’s office. With each patient appointment, medical billers update the patient database with new diagnostic information. This way, patients receive the proper medical care they need from their physician and pharmacist, while the insurance company knows what type of coverage to provide.

Medical Coding

Medical Billers are also responsible for learning Medical Coding. Essentially, the diagnostic information you receive from the doctor will be in the form of an alpha-numerical code. Each of these codes will stand for different diagnoses, medical procedures, testing, injections, and specialist referrals that you will be responsible for memorizing.

These codes are established by the U.S. Government and are used nationwide. They keep medical billing and insurance consistent in order to reduce fraud, so learning these codes is your core responsibility as a Medical Biller.

Many Medical Billers create cheat sheets for these different codes and keep them as a file on their computer or as a print-out at their desk for easy reference. Making sure the codes are correct and consistent is extremely important, so double-check your entries as you’re adding the patient information to the database.

Record Keeping

Along with coding and billing, Medical Billers are responsible for keeping the records of all patients that come in for an appointment. Electronic medical records (or EMRs) are a way to keep all patient information organized and accessible, and you will be trained on database management, as well as privacy and patient access laws, so that you can perform your record keeping duties correctly and efficiently.

Just as you input all medical billing and diagnostic information, you will also be responsible for insuring that these EMRs stay up-to-date with each patient visit and that any changes in insurance, diagnosis, or address is updated immediately.

Patient Responsibilities

Just because you work with records and insurance companies does not mean you don’t get to interact with patients. Not only are you responsible for ensuring that patients get the proper coverage and care they need but you also act as the liaison between the patient and their insurance company.

Should problems arise where coverage is not given or a patient is charged the wrong amount, you will intervene to address the issue and correct the error. Sometimes you will have to collect if payment is not received, and other times you will reimburse patients that were charged incorrectly. In order to avoid negative interactions with patients or their insurance companies, always double-check your data input and make sure you are using the proper codes for each and every diagnosis.

Is Becoming a Medical Biller and Coder Right for You?

A Medical Biller and Coder is a vital part of the medical team. Working with doctors, patients, and insurance companies ensure that each party is diagnosed and billed correctly for medical services.

Your job is of the utmost importance, because you are responsible for not only making sure the patient receives the proper coverage but also for protecting patient identity by inputting data and codes correctly. If this sounds like the perfect job opportunity for you, view our updated healthcare class schedule and enroll now to become a Medical Assistant.