In the Healthcare field, Medical billing is one of the fastest paced career opportunities. Medical Billing is all about healthcare providers charging the patients appropriately for all legitimate services rendered without overbilling.
Medical Billing would definitely be a best career path with abundant job opportunities especially for Life Science students and for also those from other backgrounds, who really wanted to invade billing field. Medical billing and coding are ruling the health care sector with faster growth rate at over 15-18% per year on average. This demanding growth has opened up wide variety career opportunities for students and skilled candidates. Well, if you are interested to shape your career in medical billing, go through the below basics about medical billing process, how and where to start with career? Happy Reading!
What is Medical Billing?
In Today’s World, Medical billing is said to be a complex and essential part of the health care system. Medical Billing is to prepare the bills (invoices) for the services rendered to the patients (medical procedures), and the prepared bills are submitted to patients and the insurance companies. Medical Billing procedure coordinates or plays an intermediary role between patients, providers, and the payers.
I hope by now, it is clear that the Medical Billing involves billing process in health care field. It provides bills for the reimbursement procedures for both patients and insurance companies. Healthcare providers require medical billers for all the reimbursement procedures and transmission of important data through medical coding. Health care setups and Medical practices usually rely on the medical billers for claim processes and reimbursements for the steady flow of revenue. This piece of article aims to provide guidance for medical billing, certification courses, billing work profile and career opportunities as well.
Medical insurance occupies a major role due to several health concerns hitting humans on the Earth. Medical billing creeps into the management and extraction of patient data about health-related issues and procedures to make a report for claiming insurance. Medical billing is of two different types like: professional billing and institutional billing.
Why to Choose Medical Billing?
It’s a best time to choose Medical Billing as career, as there are great job openings in medical billing as well as coding. Medical Billing is a potential field which is expected to grow exponentially in the coming years. Medical Billers are in great demand with the most rewarding and challenging career opportunities across the globe. Medical Billing filed is also a right path for those aspirants who are willing to opt for career change in future.
It’s no wonder to say that India has become a hub for medical billing outsourcing. Outsourcing medical data like billing or coding has become a common practice in the United States healthcare domain. In India, Medical Coding-Billing industry has already boomed providing healthcare claims and medical data transmission for major counties like USA, UK, Australia, Middle East countries. Several studies report that India is ranked as the number one outsourcing offshore destination for Medical billing for USA & Europe.
Medical billing is one of the stress-free jobs, good job timings, full or part time opportunities, work from home.
Education and Skills required in the Medical billing Career:
Those looking to pursue their career in billing require relevant Bachelors or Master’s degree and certification if required. Medical Billers and coders must have an understanding of medical terminology, laws and ethics related to health insurance, medical billing and the Health Insurance Portability and Accountability Act (HIPAA). It’s is not must to have a PG degree for the medical biller Jobs, experience with additional specialized training programs (classification systems – ICD-9, CPT, DSM-IV and HCPCS) or certification may also bring good Job opportunities.
|Education||Required Skills||Education Mode & Places||Job Roles||Salary|
|Bachelor’s degree (Health care, accounting, finance, business and administration, Any relevant Associate degree, High school diploma or equivalent, Certification courses in medical billing and coding (CPC, CPB).||Analytical skills, mathematical knowledge, communication skills, verbal, written skills, organizational skills, problem solving and customer interaction skills, proficient computer knowledge (MS Office Suite), typing skills, database management, law regulations, healthcare regulations, etc.||Colleges, and private schools, Universities, Academic institutions, etc.||Medical records and health information technicians, medical transcription executives, insurance claims in charge, policy processing clerks, bill collectors, account collectors, accounting, auditing clerks, information clerks, medical Assistants, healthcare administrator, etc.||20-30 lakhs PA annum|
Online courses & Offline courses
- Associate’s degree programs: Two years with general education curriculum.
- Certificate and diploma programs take around a year time.
- Bachelors Program: Four years of time period.
Organizations like National Healthcareer Association (NHA), National Center for Competency Testing (NCCT), American Health Information Management Association (AHIMA), Registered Health Information Administrator (RHIA) and The American Academy of Professional Coders (AAPC), etc. offer certifications and conducts exams for crediting certifications. Few of the courses include as below:
- Certified Professional Coder (CPC)
- Certified Professional Biller (CPB)
- Certified Professional Medical Auditor (CPMA)
- Certified Documentation Expert Outpatient (CDEO)
- Certified Professional Compliance Officer (CPCO)
- Certified Physician Practice Manager (CPPM)
- Instructor Certification
Certifications would make you expert in the subject, to learn more about medical terminology, international codes, insurance types, medical billing regulations, claim procedures. It would be an additional eligibility though not mandatory.
Accreditations: Always chose medical billing training from the recognized bodies and make sure they are accredited by official or authorized bodies like American Health Information Management Association (AHIMA), Commission on Accreditation of Allied Health Education Programs (CAAHEP) and other Regional accrediting bodies. Certification from such accredited bodies will only add value to your career growth.
What Medical Billers do?
Medical billers are responsible for the timely submission of technical or professional medical claims to insurance companies from hospitals, physician offices, nursing homes or other healthcare facilities. Medical data storage includes all particulars about the patients, medical diagnosis, treatment procedures, chart details, insurance plans, claims data submission, doctor’s remarks, billing, account information and settlement records.
Medical Billers process the medical services provided to patients and then submit claims to respective insurance companies. Medical billers are responsible for the whole process till the completion of claim settlement. Medical practices and healthcare facilities and insurance companies rely on medical billers to follow billing claims and reimbursements for a steady stream of revenue.
Medical billers are also designated by roles such as hospital billers, accounts receivable billers, billing specialists, medical biller clerk, medical billing specialists, medical billing supervisor, medical records coders, medical collectors and patient account representatives, etc.
Duties of Medical Biller include:
- Patient data Registration: Complete information of Patient (Identity details, contact information, insurance details, medical history and medical reports) and need to be registered successfully, missing information can be collected from patients.
- Patients Insurance Verification: A proper review need to be done on patient’s insurance eligibility, coverage, other referrals and applicable benefits.
- Medical Coding or Transcription: Patient disease, symptoms, diagnosis, medical procedures coding can be done by Medical coders with specific alpha numeric coding (Accurate CPT, ICD, HCPCS Codes).
- Coding Compliance Checking: Cross checking codes given to the patient data and need to ensure the data and codes entered are correct.
- Demo Entry: This step includes the entry of patient demographic information (patient’s name, gender, date of birth, place, contact number, email, address, marital status, etc.) and insurance plan into the system at the billing office.
- Charge Entry: Patient accounts need to be created and the coded documents need to be sent to charge entry department. Charges need to be entered accordingly for the medical procedures, and services provided.
- Billing Data: All the billing data need to be entered to billing software’s following specific guidelines (i.e., medical billing codes), Data is saved both in soft copies and hard copies as well.
- Claim Submission: All the created medical documents are sent to the insurance payer for payment. Claim submission has several guidelines to be followed.
- Payment Posting: This step of payment posting is one of key process involved in Medical billing which generates accounting to the handle or view patient bills. The amount billed to the patient will be adjusted accordingly by the payment status from insurance payers.
- Follow Ups: Maintain a tracking of payments, monitoring late payments, payment timelines, and initiation of notices or follow-ups to late payments.
- Reimbursements and Final Settlements: In this stage, expert medical billing team follows up with the insurers and payment agencies for the final bill settlement or the reimbursement.
- Denial Management: The submitted claims will be checked for any errors in the documents provided. Every detail will be cross checked thoroughly and final approval will be given. Any mismatch details or missing documents or codes will not be given approval at clearing house. The rejected claims will not be moved into further steps of approvals by the insurance company.
- Complaints Management: Responding timely and properly the concerns or queries from patients as well as insurance companies. Need to answer all the raised questions with a proper solution. Financial discrepancies need to be monitored well.
- Billing Records & Confidentiality: All the billing files need to be documented or recorded properly with all the updated information. Patient information need to be maintained confidentially.
- Medical billers need to clearly update and review all accounts to keep track record of payments up-to-date.
- On a final note, Medical Biller is responsible for calculating medical expenses or bills and collecting payments for those medical services provided to patients.
- Medical biller needs to have the ability to multitask when needed and manage time effectively.
Sounds pretty job description, right? Other medical biller responsibilities include, clarifying any discrepancies, scheduling and arranging payment plans for patients, obtaining prior approvals for specified procedures if required, reviewing medical bills.
Where do Medical Billers work?
Medical billers work is necessary at various sources like hospitals, physicians’ offices, clinics, health care settings, insurance companies, medical data, medical transcription, coding and billing companies, law and government bodies, educational institutions (training purpose). Expert medical billers chose to work from home.
There are different types of medical billing companies: small-scale medical billing services, professional medical billing business and physician practice management company based on the volume of the data and financial budget.
The outlook for a career in medical billing is expected to be good over the coming years. India is growing out to be a healthcare hub in terms of outsourcing. Medical Billing can be a career option for any graduates with or without higher degrees.
India is standing as a leader for being the best offshore medical billing destination and so lots of opportunities arises for the medical billers. India is chosen for its advantages in Medical billing outsourcing that include: cost effective being number one, expert and professional service, availability round the clock, quality of deliverables, no language barrier (English), and data security.
One can find suitable jobs in medical billing and also can startup to outsource medical billing service.
Setting Up Medical Billing Service:
Medical billers can also work from home option. To work comfort from home, they can opt flexible home-based career in medical billing or can also setup their own business. Medical billing service business can be also an option to earn in the field operating from a more comfort zone. All the legal notes should be considered for the works opted, to avoid being trapped. One can start own business from roots or can also buy an already existing medical billing business to easily find the grip into business.
Also, Independent medical billing experts have the option to choose freelance projects. Working hours and work location can be as per the choice. Medical billing career offers opportunity to earn better income for those staying at home after education, busy with home affairs and family priorities. Many online Job portals post relevant posts on hiring medical billing expert to review the medical services.
Salary Expectations for Medical Billing:
A medical biller’s earning potential varies depending on where they live, work, how much they work, education, certifications, and their experience. American Academy of Professional Coders conducts an annual survey on salary trends in medical coding and billing fields. US Bureau of Labor Statistics (BLS) categorized medical billers into the role of medical records and health information technicians. Year by year, salary growth shows a higher rate of increase. There is a trending increase of average salary with experience, updated technical knowledge and required skills. The salary is also dependent on factors like location, facility size, work hours, and other factors.
Perfect Resume-Career in Medical Billing:
Building a perfect resume fetches good chances to explore opportunities. Always a resume should depict the best in you including apt career objective-briefing an overview of experience and skills, summary of qualifications, relevant work experience-highlighting medical billing experience, technical skills, other important skills, and expertise, certifications, affiliations (if any) and references. A resume should also contain three to four sentences regarding personal introduction, and potentials that the benefit the hiring company. The resume needs to be different for different job applicants in medical billing, it differs with the freshers, experienced and looking for managerial position. It is always required to present a compelling resume that convinces employers that you have the desired qualifications, experience and skills they are looking for the current job position recruitment.
Have a glance through the below list of Medical Billing companies in major countries and India: Medusind, Elite Offshore resources, Pivotal MD, Omega, Ecare India Pvt. Ltd., Ascent Business Solutions, Allzone Management Solutions, Eminence Healthcare Services, DME/HME Medical billers, HealthQuist, HealthQuist, QWay Health, Medryte, Omni Medical Billing Service, Medphine, Curemd, Advancedmd, 4dglobal, Omegahms, Della, Access healthcare, Outsource2india, P3 Healthcare Solutions, MocDoc, Bikham Healthcare, Voxdoc, GreenPoint Healthcare, United health group, Pacific- Global BPO, Magnet Medical Coding Solutions, GroupOne, GeBBS, Vee Bill, Nissi Billing, AllZone Management Solutions, Medisweans, Penta IT Services Private Limited, etc.
Training on Medical Billing:
It’s a herculean task to choose best training center for any courses, the same applies to medical billing courses too. Always a best medical billing training requires quality school or institute with academic knowledge, practical knowledge and most importantly updated technologies. It would be beneficial for career beginners, if the training allows externship in healthcare facilities, hospitals, etc. Medical billing courses includes all the syllabus ranging from basic computer knowledge, medical terminology, physiology, anatomy, billing software’s, insurance topics. Every training program will differ with other in terms of teaching modules and syllabus.
A Perfect Career Guide – PKC:
What’s better for next step? Many questions striking, Tired of web searches, lack of requisite skills, limited knowledge, uncertain career plans and what not? Put a Full stop to all your worries and confusion in moving through the smoother career path. Here comes an ultimate solution and a perfect guide “Pharma Knowledge Centre (PKC). Right form selecting your course to making you ready for the Industry, it’s all in the hands on PKC. Services offered by PKC include exclusive training, high end consultancy, accurate recruitment-placement, enterprise review,
If you have any questions or queries about medical billing career, please feel free to contact us by email: firstname.lastname@example.org or simply call PKC on +91 8318127735. You’ll definitely find answers to all your questions. Hope you land well in the desired field and position.
Happy Billing Experience with best medical billing career ahead. Medical Billing can surely bring ultimate career settlement jobs.
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