Medical Biller Specialist Job Description Template
As a Medical Biller Specialist, you will manage patient billing processes, submit insurance claims, and ensure accurate and timely reimbursement for medical services. Your role is critical in maintaining the financial health of the healthcare organization and ensuring compliance with all regulations.
Responsibilities
- Review patient records and medical documentation for billing accuracy.
- Submit insurance claims and follow up on claim statuses.
- Correct and resubmit denied claims to optimize reimbursement.
- Communicate with insurance companies to resolve discrepancies.
- Ensure billing compliance with healthcare regulations and policies.
- Maintain accurate billing and insurance records.
- Assist patients with billing inquiries and clarifications.
Qualifications
- High school diploma or equivalent; additional certification in medical billing or coding preferred.
- Minimum 2 years of experience in medical billing.
- Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding.
- Proficiency in billing software and electronic health records (EHR) systems.
- Excellent attention to detail and accuracy.
- Strong communication and interpersonal skills.
Skills
- Medical coding (CPT, ICD-10, HCPCS)
- Billing software proficiency
- Electronic Health Records (EHR) systems
- Insurance claims processing
- Regulatory compliance and HIPAA
- Attention to detail
- Communication skills
Frequently Asked Questions
A Medical Biller Specialist handles billing processes in healthcare facilities. They are responsible for translating healthcare services into billable charges, submitting claims to insurance companies, and ensuring accurate reimbursement for healthcare providers. They also address discrepancies, manage account updates, and ensure compliance with federal regulations.
To become a Medical Biller Specialist, one typically requires certification in medical billing and coding, often obtained through accredited programs. While some positions may only require a high school diploma, completing an associate degree can improve prospects. On-the-job training is often provided, but candidates benefit from knowledge of medical terminology and proficiency in billing software.
The average salary for a Medical Biller Specialist varies by location, experience, and type of healthcare facility. Typically, professionals in this role can expect competitive compensation with the potential for benefits such as health insurance and retirement plans. Those with advanced skills or certifications may attract higher salaries.
A Medical Biller Specialist often requires a certification in medical billing and coding, alongside a good grasp of medical terminology and healthcare regulations. Employers may prefer candidates with experience using billing software. Essential skills include attention to detail, organizational ability, and strong communication for liaising with payers and providers.
Skills essential for a Medical Biller Specialist include proficiency in billing software, attention to detail, and knowledge of insurance claims processing. Responsibilities encompass preparing and submitting healthcare claims, monitoring accounts for payments, correcting errors, and coordinating with insurance companies to ensure timely billing and resolution of inquiries.