Medical transactions can be a complex process with consumers, insurance providers and medical facilities all becoming involved. To ease this complexity, medical insurance billers communicate with insurance carriers about payments and keep close track of procedures performed on patients and the correct billing codes to use for reimbursement.
Medical insurance billers help hospitals, doctors and other medical facilities obtain payments from medical insurance providers. They determine which procedures were performed on patients and then send out medical billing invoices to insurance carriers. These professionals usually learn their skills through certificate or associate's degree programs that include medical billing coursework, with additional coursework in medical coding also commonly included.
|Required Education||Certificate or associate's degree|
|Projected Job Growth (2014-2024)||15% for all medical records and health information technicians*|
|Median Salary (2016)||$35,230 annually for medical billing specialists**|
Sources: *U.S. Bureau of Labor Statistics, **PayScale.com
The U.S. Bureau of Labor Statistics (BLS) showed that workers in the medical records and healthcare information industries, such as medical insurance billers, use patient records to determine what to charge medical insurance companies for services rendered (www.bls.gov). Medical insurance billers input patient chart information into medical billing databases to notate which medical procedures were administered. They calculate the expenses for services and then prepare itemized lists for billing statements and health insurance invoices. Sometimes billers have to submit additional notation to insurance companies if a bill has been denied.
Between 2014 and 2024, the BLS predicts that open positions for workers in the medical records and health information industries will increase by 15%, faster than average for most occupations. An aging population and their need for more medical tests and the increasing use of electronic health care records should contribute to this growth.
The BLS reports that most health information technicians and medical records specialists enter the work force with an associate's degree. There are also certificate programs available that train workers to become medical billers. Coursework in medical billing includes medical finance and insurance, medical terminology, computerized medical billing and confidentiality compliance.
Most medical billing certificate and degree programs also teach courses in medical coding. Medical codes are assigned to medical procedures, and these codes are used by medical billing database computer programs to determine reimbursement rates. Medical coders review patient charts and write down the appropriate medical codes that need to be inputted into the system by medical billers. Some medical billers work as both billers and coders, but this varies by employer.
Medical coders facilitate and oversee payment processes for medical facilities by collecting payments from insurance companies and keeping record of patient procedures. They must have great communication skills, and be organized and knowledgeable about the medical billing process.