Medical billers are responsible for submitting claims to insurance companies and other payers, such as Medicaid and Medicare. Large medical institutions to small practices employ medical billers to ensure their claims are coded correctly and that they are submitted to payers and insurance providers in a timely manner so the billing cycle progresses unimpeded.
As you craft the skills section of your medical biller job description, you should highlight that your ideal medical biller is detail-oriented, highly organized and efficient. This person should also have extensive knowledge of basic insurance structures, including HMOs, PPOs and other systems.
Additionally, medical billers should possess above-average computer skills and have a basic knowledge of accounting and billing procedures. This medical biller job description can guide you as you put together your own job posting to fill an open spot at your organization.
Medical Biller Job Summary
As a medical biller at our growing family practice, you will be an essential member of a patient-oriented team that prides itself on providing excellent medical care. In addition to submitting claims and working with insurers on a day-to-day basis, you will have the opportunity to interact with patients and answer any questions they might have about the billing process. This is the perfect position for a medical biller who has a few years of experience but wants to further expand her or his skills and abilities. Strong organizational and customer service skills in addition to the ability to work in a patient-oriented environment are needed for this role.
* Obtain pre-authorizations and referrals as they are needed for patient referrals
* Review patient bills to ensure they are complete and accurate, and obtain any needed information if it is missing
* Use billing software, including paper claim processing and paper claim processing programs, to review, prepare and transmit claims to the appropriate party on a daily basis
* Check to see if claims remain unpaid and follow up with patients and insurance companies to determine the cause of the delay and to keep the billing cycle on track
* Look into claims that are denied and research how to modify the claim to ensure it is processed correctly
* Answer inquiries made by patients or insurance companies regarding assigned accounts, the billing process or the appeals process
* Work with patients to set up payment plans and manage collection accounts as they are processed
* Update office billing software with rate changes, run collection reports and update cash spreadsheets as payments are received
Job Skills & Qualifications
* High school diploma
* Strong knowledge of basic accounting and billing procedures as they apply to the medical industry
* One to three years of experience in a medical office setting
* Medical billing certificate
* Experience working with HMOs, PPOs, Medicare and Medicaid
* Familiarity with standard medical billing software
Medical Biller Job Responsibilities
As an administrator, you understand the importance of a well-written document. After all, you’ve probably spent some time sorting resumes that impressed you from those that appeared rushed and unorganized. Your medical biller job description should reduce the number of disappointing resumes. By using the right focus, word choice and formatting, your job responsibilities section can filter out unqualified or overqualified candidates.
Focusing on meaningful content is the first step in writing an effective medical biller job responsibilities section. While it’s the most comprehensive portion of the job description, you don’t want to list everything the jobseeker should plan to accomplish. Instead, choose between six and eight of the most important points. The second step is to begin each responsibility with an action verb that clearly describes the work a future employee will do. Finally, format this section with bullets for quick and easy reading.
Here is a selection of responsibilities you could choose for your medical biller job description:
- Collect delinquent accounts, make payment arrangements, track payments and follow up with patients
- Coordinate with collection agencies and small claims court, pursue legal remedies and testify on behalf of the hospital for court cases when necessary
- Track billings, monitor collections and compile information to maintain bad-debt cost reports
- Convert medical dosages to billable units
- Submit billing information to insurance providers
- Perform regular billing and insurance reviews and audits
Medical Biller Job Specifications
Because the job qualifications and skills section of a medical biller job description is typically the shortest portion of the listing, many professionals mistakenly assume that creating it requires little thought. However, it’s crucial that you give this section the attention it deserves because it emphasizes your desired minimum requirements. It also should focus on education prerequisites, areas of specialty and a selection of preferred soft skills.
You’ll find that jobseekers use the credentials section to determine if they have the right qualifications for the position. When you lay out exactly what you expect, you’ll keep your inbox free of applicants who simply aren’t a good fit.
Ensure the successful choice of medical biller job specifications by talking to your hiring manager about required qualifications. Also ask about any skills that would enhance a jobseeker’s chance of gaining employment. Be sure to keep these lists separate in your medical biller job description so applicants can easily understand what you’re looking for.
Here’s a list of some of the qualifications and skills that could be valuable additions to your job description:
- Proficiency with electronic medical records and related software, especially MS Access
- Familiarity with legal compliance requirements and ability to communicate any breaches in compliance
- Knowledge of accounting and business processes
- Good independent and collaborative working skills
- Associate degree plus 2 years of experience required
- Bachelor’s degree in business or related field, preferred