What Does a Medical Biller Do?

Felicia Dye

A medical biller is an individual whose job is to prepare bills for goods and services rendered by health care providers. There are some medical billers who work for third-party agencies or who are self-employed, but many are directly employed by health care facilities. These individuals spend most of their time working on computers using software that helps them to prepare invoices that are appropriate for the parties responsible for making the payments. Medical billers are also commonly responsible for ensuring that the bills are sent out in a timely manner. This job does not generally require a college degree, but preference is often shown to individuals who have one.

After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.
After a medical service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid.

When individuals seek medical treatment, the services or goods that they receive, such as laboratory testing and casts, are recorded in the their medical records. After each service is provided and recorded with the appropriate code, a bill needs to be created so that the health care provider or facility can get paid. This is where the medical biller comes into the equation.

The medical biller's job may begin with her gathering and organizing the records from a patient's visit. She will want to make sure that she includes all charges to avoid financial losses or disputes over partial bills that are sent later. It may not be clear whom is to receive the bill initially. As some individuals may be covered by one or more insurance providers, the medical biller may have to contact these companies to see what they are liable to cover. She will then need to compose bills for each responsible party, including the patient if there are goods and services that the patient must pay for herself.

Much of the work involved with preparing medical bills is done using computer software. Medical billers need to be computer literate, and they may need to be familiar with the billing programs before they are hired. There are not currently any laws in the U.S. that require these individuals to have any college degree or certification, but there are educational facilities that offer coursework in this area, and it is often helpful to obtain it. This is especially true for those individuals who plan to start home businesses in this field.

Medical billers need to be detailed oriented, because when they make mistakes, the result is often refusal or delay of payment. It can also result in patients getting frustrated and seeking services elsewhere because they believe that their health care providers are trying to cheat them. Other skills that are recommended for medical billers are proficiency in math, anatomy, and medical terminology.

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