Advances in technology have changed many aspects of healthcare, including the way medical billing is handled. Most healthcare facilities, whether it’s a private doctor’s office or large hospital, rely on certified medical billers to make sure that insurance claims are submitted properly. Many medical billers also have training using medical codes and coding software. There are several coding systems, and a medical biller and coder must know how to classify different kinds of medical procedures correctly.
Job Description
Medical billers often do more than document procedures and submit insurance claims. If a claim is denied, the medical biller investigates the reason for this and resubmits the claim. They may be responsible for scheduling patient appointments at a doctor’s office or clinic, verifying patient insurance information, and adding documentation to patient records. An organized medical biller helps the medical facility function more smoothly—and ensures that the healthcare professionals get reimbursed for services performed. Attention to detail, good computer skills, and the ability to communicate effectively with doctors, patients, and insurance bureaucrats are necessary attributes for a medical biller. You will also be required to understand medical and pharmacological terminology, and the complexities of insurance reimbursement policies.
To get started in medical billing jobs, you need training and then certification by a professional agency. Renewing your certification ensures that you are up-to-date on coding systems and reimbursement policies and procedures in this fast-growing field. Here’s how to become a medical biller.
Medical Billing and Coding Training Programs
Medical billing and coding programs are offered by community colleges, vocational schools, and online. Make sure you choose a program that is accredited by the American Academy of Professional Coders or the American Health Information Management Association.
There are three kinds of medical billing degrees you can pursue after completing high school:
- Certificate degree (9 to 12 months)
- Associate degree (2 years)
- Bachelor’s Degree in health information management or health care administration (4 years)
You may decide to start with a certificate degree for an entry-level medical billing position, and take more advanced training later on if you want to advance or get a particular professional certification.
All medical billing specialists must learn to use standardized coding indexes and software. Basic courses in human anatomy, disease processes, medical procedures, and medications are necessary, as well. More advanced coursework includes computer science, statistics, and insurance policy. No matter what degree you choose, you will need to be certified before starting to work as a medical biller.
Medical Billing Certification
Several professional organizations offer certification to medical coders and billers. You will need at lease a high school diploma and sufficient training to pass the exam. Each agency has its own regulations and requirements for renewing these certifications.
- American Health Information Association (AHIMA): This offers a Registered Health Information Technicians (RHIT) credential through an exam to applicants with an Associate’s Degree in Medical Billing. Additional coding credentials are offered. All credentials must be renewed according to particular schedules and with specific continuing education requirements.
- American Medical Billing Association (AMBA): This offers a Certified Medical Reimbursement Specialist (CMRS) credential through an exam. The credential must be renewed annually after taking 15 credit hours of continuing education courses.
- American Academy of Professional Coders (AAPC): This offers a Certified Professional Coder (CPC) certification through an exam to applicants with an Associate’s Degree in Medical Billing, two years of medical billing experience, and membership in AAPC. The credential must be renewed annually with 36 credit hours of continuing education every two years.
Job Prospects
The job outlook for medical coders and billers is excellent. An aging population and the adoption of a greater number of standardized medical tests and procedures make the services of coders and billers more necessary. Positions are available with hospitals, doctor’s offices, insurance companies, nursing care facilities, clinics, retirement homes, pharmacies and government health care agencies. Some medical billers establish their own businesses and work on contract from home.
Salary
Salaries for medical coders and billers vary, depending on the business. Those working at federal government facilities or hospitals earn more than billers at doctor’s offices or outpatient care facilities. The average annual salary range for this position is $25,570 to $32,350. Salaries also vary depending on the region of the country and educational experience.
Dealing with medical billing codes and insurance forms is not for everyone, but if you are organized, precise, good at problem-solving, and want to be part of a health care team, a career in medical billing might be for you.