Published by Lookforzebras
Are you looking to launch yourself into a non-clinical healthcare career as a medical billing specialist/medical collections specialist or a medical coder? First of all, to distinguish between medical billing specialists and medical coders; Medical coders work with patient data to assign appropriate codes which helps to accurately process insurance claims. Medical billing specialists interact directly with patients. As a medical biller, you are responsible to interact better with the insurance companies and enable the processing of insurance claims.
Medical Billing and Coding can be an interesting and challenging career. In this nonclinical career, you juggle multiple responsibilities and it will seem as if you are swimming against the tide. But there are definite benefits that you can reap when you embark on this career.
First, we address a few questions about what is involved in a career as a medical specialist and then discuss the pros and cons.
Who is a Medical Biller?
A medical billing specialist or an associate is an individual who plays an important role in the active medium between healthcare providers, insurance companies and healthcare organizations and patients. Medical billers manage all the financial transactions of a healthcare organization.
As a medical biller, your function is to work as the front-desk officer, keep track of medical records and keep medical bills and ensure the accuracy of the transaction reports. You will send the health insurance reports to the insurance office promptly. You will create accurate, legal bills for the medical patients in your healthcare facility and also collect payments from the payments/insurance companies promptly.
In this role, you will act as an insurance billing specialist. You will maintain the confidentiality of patient records and other information as per HIPAA regulations. You will also liaise with the insurance regulators regarding payment delays and non-payments.
Role of a Medical Billing Specialist
You will liaise with the different departments in a healthcare organization; whether it is a healthcare provider, medical professionals, insurance providers and other parties. The job position is exceptionally critical for every department for ensuring the proper financial cycle of the healthcare sector. You help medical companies fulfil their medical responsibilities.
Work Responsibilities of a Medical Billing Specialist
Medical responsibilities of a medical biller include:
- Collecting information from the patients
- Ensuring data accuracy
- Preparing the insurance plans
- Submitting the medical claims
- Preparing medical bills
- Collecting and reviewing pre-authorizations as required for further procedure
- Using the billing software and updating the billing software with the rate changes
- Preparing medical invoices
- Following up with insurers for claim settlement and also analysing any discrepancies in payments.
- Account for Coding and abstracting for patient encounters
- Research and analyze the data needs for reimbursement.
- Ensure that all codes are entered according to government and insurance regulations
- Ensure that all medical records are filed and analyzed properly.
Pros and Cons of working as a Medical Billing Specialist
There are relatively low barriers to entry to enter this field as a medical billing specialist. The many advantages in this field are listed below:
- This career path does not require many years of college. You can immediately launch yourself in this career after a short-accredited program. It can take anywhere between 7-24 months, depending on the type of program you choose. You can get such accreditation after completing high school or GED.
- Online training is available. The benefit of online training is that you can complete this either during the day or at night. You will also be able to take up a full-time job and do the course part-time.
- The training cost is relatively lower compared to other medical careers. The cost to complete a medical biller’s program is anywhere between US $1,000 to US $3,000. So, if you are interested in the medical billing and coding field, you can do this at a relatively low cost.
- There is room for advancement. After joining as a medical biller, you can progress in this field in the following areas: Practice Management, medical auditing, compliance, clinical documentation improvement, education and so on. You can also become a specialist in electronic medical billing or cardiology billing. With each career advancement, you are eligible to receive a higher salary.
- For those who seek to work from home, these types of work-from-home jobs are available. If you are living in an area with frequent snow or where your workplace is too far away to access daily, this can make an ideal career for you. You can work as a remote billing specialist. for multiple parties.
- You have an opportunity to work as an independent contractor. This way, you can work for multiple medical facilities or healthcare facilities. This way you can also dictate where you will work. As you are working from home, you can set your own timings and work for whomever you please.
- You can work in a variety of settings. You get an opportunity to work for different employers like insurance companies, health insurance companies, medical practices, rehab facilities, long-term care facilities and independent professional billing facilities.
- In this field, there is a large demand for medical billers as there is a short supply of staff in this field. There are openings available even for retired 60–70-year-old people.
- As a medical biller, you can enjoy perks like health benefits, extra time off and paid vacation etc.
- Predictable work hours. You enjoy a 9 to 5 schedule typically. This means you have a better work-life balance and enjoy time with your family.
Disadvantages of Working as a Medical Biller
- Lack of a High school diploma or GED can be a disadvantage. If you are not academically bright, maybe this is not the perfect career for you. Along with this, you need a certification, learn codes and be responsible for an important function in the medical ecosphere.
- You must keep yourself updated with the latest computer programs, be able to use a computer and spend most of your time sitting. Constant sitting can lead to many lifestyle diseases.
- Your entry-level salary is not that lucrative but you must also remember that this is also in line with the basic certifications and credentials. Of course, you will earn more when you rise in the hierarchy and develop more skills. You could even become a health services manager.
- Dealing with third parties – You may experience a stressful time dealing with third parties like insurance companies and getting the medical claims of patients settled. This can be quite taxing. You may also deal with government bodies to verify the benefits available for a patient under Mediclaim or Medicaid.
- A lonely career – Constantly working from home can make for a lonely career.
Salaries for a Medical Billing Specialist
The median medical billing and coding salary according to the U.S. Bureau of Labor Statistics is US $44,090 per year. Salaries are around US $55,923 per year as per a study conducted by the American Academy of Professional Coders. As you get professional certifications and improve your skills, your salary also improves.
Having a relevant certification in medical billing and coding, such as Certified Professional Coder (CPC) or Certified Professional Biller (CPB) from organizations like AAPC or AHIMA, can often lead to higher salaries.
Medical Billing Specialists can work in various settings and locations, including hospitals, clinics, private practices, and billing companies; salaries can vary depending on the type of employer and the location.
The Future Outlook for Medical Billers and Coders
The Bureau of Labor Statistics has revealed that medical billing and coding jobs are expected to increase by 15% up to 2024. This number is also expected to increase to 30% by 2029. This means an additional 30,000 jobs by 2029. Many of these jobs are also expected to be lucrative. Medical billers and coders are in demand, enjoy flexible work hours and also make a difference in the community.
Medical billers and coders are a very important lifeline in a complex reimbursement process or revenue cycle. Medical coding and billing serve as a common language for medical billers and coders for health providers and payers. You drive the rules around reimbursements. You work in different aspects of the medical billing cycle like patient experience, claims submission and denial management. This becomes the cornerstone which decides the quality of patient care.
A Medical Billing Specialist ensures healthcare providers receive accurate reimbursement for their services by translating medical procedures into billing codes.
Salaries for Medical Billing Specialists vary but typically range from $30,000 to $60,000 per year, depending on factors like location and experience.
To become a Medical Billing Specialist, start with a high school diploma, then consider relevant education or certification programs. Gain experience through internships or entry-level positions.
Common certifications include Certified Professional Coder (CPC) and Certified Professional Biller (CPB) from organizations like AAPC or AHIMA.
Success in medical billing requires attention to detail, knowledge of medical coding, strong communication skills, and familiarity with insurance regulations.
Look for job openings on job boards, healthcare websites, and reach out to local hospitals, clinics, or billing companies for potential positions.
With experience, you can advance to roles like billing manager or consultant. The demand for these professionals continues to grow as the healthcare industry evolves.