What Do Medical Billers Do, Exactly?

Medical billing specialists work in one of our nation’s rapidly growing occupations. They’re in demand! And with the increase in demand for healthcare services, especially with our aging population, these critical workers have projected employment growth of 22% by 2026.

But what exactly do medical billers do?

In this post, you’ll find out what it’s like to work in the world of medical billing specialists. You may even decide it sounds like an intriguing career choice for you. 

Read on and explore this fast-growing healthcare specialty.

Top Responsibilities of Medical Billers

Hospitals and medical practices love their medical billing and coding specialists. In this section, you’ll see why.

A Medical Biller is responsible for organizing patient medical costs. They compile the costs for each patient’s treatment into an invoice, which goes either to the patient or their insurance provider.  

These critical medical team members are often the first point of contact for patients who have questions about their bills. As such, medical billers also include contacting patients to discuss payment or help them set up reasonable payment plans.

The medical biller enters patient data into the healthcare provider’s administrative system. These systems don’t only hold information about patient invoices. They also record information on outstanding insurance claims.

Medical Billing and Document Review

The daily responsibilities of a medical billing specialist include reviewing and completing all the documentation concerning insurance billing and payments.

They must obtain referrals and pre-authorizations for procedures. Once the healthcare provider completes the procedure, the medical biller prepares, reviews, and transmits claims to the insurance company.

Of course,  follow-up is critical. Most people who work in a medical billing office spend a considerable amount of time researching unpaid claims, updating spreadsheets, and running collection reports.

Medical billing professionals also spend considerable time learning what procedures insurance providers will cover. That includes Medicare and Medicaid.

Medical Billing Specialists Are Good Communicators

Beyond the attention to detail necessary for success in their jobs, medical billers must communicate well with doctors, nurses, and other medical staff.

Doctors, particularly, often don’t have time to deal with billing issues or questions. They rely heavily on their billing team to issue invoices to patients and claims to insurance companies promptly.

That means billing specialists should develop good relationships with their colleagues and learn to communicate effectively and efficiently.

They must be skilled in reading X-rays and laboratory reports and understand what this information means to patients. Most importantly, medical billers must understand how to properly “code” (or classify) each service or item provided to a patient so that their insurance company will pay for it.

Interested in an Exciting and Rewarding Career?

For individuals who love research, can pay attention to detail, and enjoy communicating with patients and other healthcare staff, a career as a medical biller could be an excellent fit. 

For more posts about careers, health, and business (to name just a few), check out our archives. We’ve put together an eclectic collection of articles we know will interest you.