What does a Medical Billing Specialist do?
Published 4 min read
A medical billing specialist is responsible for the financial management of patient health care records. They work with insurance companies to ensure that patients receive the coverage they are entitled to, and that providers are reimbursed for the services they have rendered. They also prepare and submit claims to insurance companies, and track payments to ensure that providers are paid in a timely manner.
Medical Billing Specialist job duties include:
- Reviewing patient records for accuracy and completeness
- Identifying coding issues and correcting them
- Submitting claims to insurance companies
- Following up on unpaid claims
- Managing patient billing accounts
- Answering patient questions about their bills
- Generating monthly reports on billing activity
- Resolving claims disputes
- Training new staff on billing procedures
Medical Billing Specialist Job Requirements
Most medical billing specialists have at least a high school diploma, although some jobs may require postsecondary education, and most employers provide on-the-job training. Some medical billing specialists may choose to pursue voluntary certification. Although not required, certification may improve job prospects. Certification is available through the American Medical Billers Association and the American Health Information Management Association. To earn certification, candidates must pass an exam. Some employers prefer to hire medical billing specialists who have experience working in a medical office or with electronic health records (EHRs).
Medical Billing Specialist Skills
- Knowledge of medical terminology and coding systems
- Ability to read and interpret medical records
- Strong data entry skills
- Attention to detail
- Organizational skills
- Time management skills
- Communication skills
- Interpersonal skills
- Customer service skills
- Problem-solving skills
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How to become a Medical Billing Specialist
A medical billing specialist is responsible for submitting and following up on claims with insurance companies in order to receive payment for services rendered by a healthcare provider. They may also be responsible for patient billing, collections, and customer service. A medical billing specialist typically works in a doctor’s office, hospital, or other healthcare facility.
To become a medical billing specialist, you will need at least a high school diploma or equivalent. Some employers may prefer candidates who have completed a postsecondary certificate or associate degree program in medical billing and coding. You will also need to have strong computer skills and knowledge of medical terminology. Many employers provide on-the-job training for new hires.
Once you have the necessary education and training, you can start searching for entry-level positions in medical billing. As you gain experience, you may advance to higher-level positions such as lead biller or manager of a medical billing department. With experience and additional training, you may also become a certified professional coder (CPC). CPCs are responsible for assigning numeric codes to diagnoses and procedures in order to submit claims to insurance companies.
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