What Does a Medical Biller Do?

Medical billers fulfill an important role on the healthcare team. They perform task that ensure proper functioning of the day-to-day operations within a medical facility. Medical billers manage health billing and insurance claims for medical facilities. Their primary responsibilities include:

Transcribe and File Medical Information

As a medical biller, you will compile health information data, transcribe, and file complete medical histories of patients that are seen at your medical facilities. You will also document symptoms, examination results, treatment methods, and diagnoses prescribed by the patient’s healthcare provider.

Submit Medical Information to Electronic Health Records

The safe gathering and storage of medical information is critical to ensure that patients receive the proper treatment and healthcare. This medical information must be organized, and its accuracy must be verified, prior to entering the data into an electronic health record.

Transcribing Data into Billing Codes

Insurance companies and Medicare pay most healthcare bills in America; they need large volumes of information to process claims. Medical billers manage the process by translating medical information into alphanumeric codes that serve as shorthand.

Troubleshooting Rejected Claims

Some insurance claims are initially denied. They may be denied due to coding errors or missing data. However, the payments are critical to keep physician’s offices helping patients, so medical billers review rejected claims, working directly with the insurance company or Medicare to ensure quick reimbursement.

Why Does a Medical Biller Need to Learn Anatomy?

Medical billers don’t make clinical decisions, yet everything they do requires an understanding of how the body is made. Without an anatomy course, reading through charts to identify the health information necessary to process medical bills and fill out insurance claims would be almost impossible.

What Type of Anatomy Do Medical Billers Need to Learn?

Medical billers don’t need in-depth anatomy courses like doctors do because they don’t use the medical information to make life and death decisions. The course helps medical billers find their way around a chart by covering the 14 body systems, coding protocols and other anatomical terminology. Students learn about the:

14 Body Systems

From the nervous system to the immune system and everything in between, knowing the 14 body systems allows a medical biller to properly manage patient files, fill out insurance claims and process medical bills. Knowing medical terminology is an important aspect of the medical biller’s job.

Coding Protocols

There are three main coding protocols that you will learn during a medical billing program. The include ICD-10, CPT and HCPCS.

ICD-10 Codes

ICD-10 is one of the oldest coding systems in the world. Short for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, codes are alphanumeric and have been used globally since 1977 to classify every disease, injury or symptom known to medicine.

CPT Codes

The CPT, or Common Procedural Code, is a five-digit numeric sequence assigned to all medical, surgical, or diagnostic procedures. Developed by the American Medical Association and updated annually, CPT codes are used for both reimbursement and to gather data on treatment outcomes that are used to evaluate quality of care.

HCPCS Codes

HCPCS, or Healthcare Common Procedure Coding System, is a two-level alphanumeric system explicitly developed for CMS. Level I is the CPT index. Level II is a separate system that codes medical products from pharmaceuticals and prostheses to services such as anesthesia and radiology. There are 17 categories and counting, updates may occur as often as every six months.

What’s an Easy Way to Become a Medical Biller?

Learning medical billing on the job may leave knowledge gaps that can hamper your ability to do your job successfully. An easy way to become a medical biller is to attend a medical billing and coding program at a vocational school.

Why Become a Medical Biller?

Do you want to make a difference in the lives of others and enjoy a stable career? These are only a few of the many reasons to become a medical biller.

Make an Important Difference in the Lives of Others

Are you on the frontlines of healthcare as a medical biller? Yes, you are standing side by side with doctors, nurses and medical assistants helping patients enjoy better health outcomes. What you do as a medical biller allows doctors and nurses to see more patients and get reimbursed for health services provided to keep the lights on. The medical biller is a key team player at a medical facility.

Work in the Medical Field Without Working Directly with Patients

Are you interested in medicine but don’t want to directly manage patient care? You can still be a valuable part of the healthcare team as a medical biller and still help patients receive great healthcare. If you are passionate about medicine but not sure you want to deal directly with patients than consider becoming a medical biller.

Use Your Problem Solving and Research Skills

There is never a dull moment as a medical biller. There is always something to research or a problem to solve. Did an insurance claim get denied and you must come up with an appeal? Is a patient back due on their payments and you must create a suitable payment plan? Solving problems and doing research comes with the territory of being a medical biller. Become a sleuth and enjoy the thrill of the hunt.

Enjoy Job Stability and Future Career Growth

As the baby boomer generation ages and more patients are in need of healthcare, there will be an equal need for medical professionals. That does include doctors and nurses but also medical billers. Someone must manage the back office, insurance claims and patient billing. This means the job of a medical biller is stable, and the future is bright.

Enjoy a Sense of Independence

Although managed by physicians and nurses, most medical billers will work independently in the back office. They are responsible for their own work. However, they can ask questions if they are stumped by a problem. While still part of the overall team, if you don’t want to be micro-managed then being a medical biller may be the right job for you.

Complete a Relatively Quick Training Program

Most medical billing and coding programs can be completed in months, rather than years. No need to attend a 2- or 4-year college to become a medical biller, a formal education from a vocational school will help you stand out in the crowd of applicants and get you noticed by employers.

Final Thoughts

Now that you know what a medical biller does, what they learn and that anatomy is a small part of the knowledge you will retain from a medical billing and coding program, it is time to learn more about Meridian College. Take the time to learn about our medical billing and coding program and the opportunities it will open for your future career path.

Did learning about anatomy and medical billing interest you? Ready to attend Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical billing and coding specialist.

The post Why Do Medical Billers Need to Know Anatomy? appeared first on Meridian College.

What is Medical Billing and Coding?

Most healthcare bills in our country are paid for by private or government insurers. Medical billing and coding is the process of transcribing patient data into a billable form. Medical billing and coding specialists research charts and gather information for insurance claims forms so that physicians and facilities can receive payment for the services they provide.

What’s the Difference Between a Medical Biller and a Medical Coder?

Most medical billers and medical coders have a diploma in billing and coding. Why? Because the two fields, though different, overlap significantly. As a medical billing and coding specialist, you can choose from jobs that focus more on billing or coding, but the two roles are typically integrated because competency in both is essential to do some tasks. The difference between the two jobs lies in:

Core Responsibilities

Coders assign alphanumeric sequences to symptoms, diagnoses, procedures, and equipment for billing purposes. Without medical codes, health insurance claims forms could be chapters long. Coding reduces the volume of data to a more digestible amount.

Medical billers take it from there, completing claims forms, troubleshooting rejected claims and assisting in other parts of the billing process from invoicing patients to collections.

Work Environments

Medical billing and coding specialists work in similar environments, but there are unique opportunities for each.

Medical coders are more likely to work in clinical settings where they have easy access to patient charts and their medical team. When the documentation doesn’t contain all the information required for a claim, coders reach out to the clinicians involved in the case for additional data or clarifications.

Those working exclusively as billers are more likely to focus on financial tasks, ensuring payments are received and posted promptly. They research reimbursement issues and calculate the balance patients are responsible for paying, tracking money as it comes in. When billers discover data-related problems, they turn them over to coders for follow-up.

Because medical codes are also used by public health officials to track disease trends, coders may be employed by the government to gather and analyze data. Billers, meanwhile, are tapped for positions with an accounting emphasis. You’ll find more medical billers than coders working for independent healthcare billing companies.

Professional Colleagues

Because medical coders work more in clinical settings, they collaborate with other coders and billing specialists plus doctors, nurses, medical assistants, and other medical staff.

Billing specialists have casual contact with clinical professionals but are more likely to work with other billers, accountants, auditors and other financial or business management professionals.

Public Contact

Medical coders are the bookworms of the healthcare field. Their job is data driven, but the answers to their questions are rarely found with patients, so direct contact with the public is limited.

Medical billers, in contrast, work closely with patients. Patients are ultimately responsible for bills not covered by their insurance policies, so they may collaborate with billing specialists on inquiries and to resolve balances. Billers help set up payment plans when patients can’t pay what they owe. To work exclusively in a billing department, it’s helpful to be a people person.

What’s the Easiest Way to Become a Medical Biller or Coder?

Medical billing and coding can be too complicated to learn on the job. Did you know that some billing and coding specialists have bachelor’s degrees? But you don’t need to spend years in school to break into the field. Graduating from a vocational school diploma program qualifies you for many of the same jobs in a fraction of the time. You’ll be workforce-ready in a few short months.

What’s the Curriculum Like in a Medical Billing and Coding Program?

Vocational school programs are designed for those with limit medical backgrounds. Many students are drawn to the field because they have a background in healthcare or business. Programs prepare you for an entry-level position. Courses include:

Medical Terminology

Billing and coding specialists research medical charts for the data insurers require. You’ll review doctor’s notes, phone call transcripts, diagnostic results, and operative reports. Understanding medical jargon is a must.

The medical terminology course familiarizes you with terms and their parts, prefixes, suffixes, and roots, so that you can determine their meaning without constantly reaching for a dictionary.

Health Information Technology

The same medical records once stored in filing cabinets are now digitized and accessed via computer. Medical billing and coding programs cover the use of electronic health records (EHR) and the associated technology, from servers to databases.

Students learn how data is accessed, shared, and stored for billing purposes. Other topics include auditing, fraud detection and insurer interfaces.

Billing Procedures

Doctors are paid differently than other professionals. There are no intermediaries, for example, between attorneys or plumbers and their patients. For most students, medical reimbursement models are a whole new world.

This course is intense and covers the full range of financial issues you’ll encounter in a healthcare setting. Students get an overview of medical finance, so they understand their role and how it fits into the revenue cycle.

Topics include the types of commercial and government-sponsored insurance programs plus social programs that protect low-income patients and injured workers. You’ll learn how to handle the legal and ethical dilemmas inherent in medical billing, including patient privacy, rights and responsibilities, and collection guidelines.

Medical Coding Systems

There are three sets of commonly used medical codes describing everything from physical symptoms to disorders, surgical procedures, and ancillary services. Each is used for a different purpose and in different settings.

ICD-10 – the tenth iteration of the International Statistical Classification of Diseases and Related Health Problems, contains codes for all medical disorders. Codes are used for billing and by the government to monitor community health.

CPT – Common Procedural Terminology codes, pertain only to medical treatments and diagnostics like x-rays. They’re not only used for reimbursement purposes but also by the government and insurance companies to assess the quality of care.

HCPCS – the Common Procedure Coding System was developed specifically for the US government. It’s a combination of CPT codes and a second set of codes for services that are challenging to classify, such as infusion services, chemotherapy, and ambulance transport.

Why Attend a Vocational School Diploma Program?

Vocational schools offer students many advantages, including:

Short Training Programs

Getting a college degree is an impressive achievement, but not every student can afford to spend 4 years in school, it just doesn’t make sense for everyone. So why not attend a vocational school program? Learning is focused but no less comprehensive, and graduates qualify for most of the same jobs. It’s a great value.

A Competitive Edge

In the past, you could have gotten into the medical billing field without higher education, but practically speaking, jobs are hard to come by without a diploma. The industry is complex and highly regulated, so employers prefer applicants with standardized training. A diploma stands out on your resume and gives you a competitive edge in a tight job market, even amongst more experienced candidates.

A diploma also demonstrates commitment, showing that you take your role seriously and want to advance professionally. A diploma makes you a better investment as an employee.

Small Class Sizes

Medical billing and coding is a popular field for adults who want a second career. But far removed from the college experience, older students find the busy university life intimidating. By contrast, the small class sizes vocational schools offer is much more relaxed and creative. Instructors have more time to work with students one-on-one and peers get to know each other better.

Hands-on Learning

Book learning is valuable, but most students prefer hands-on educational opportunities. Vocational schools blend classroom learning with real-world practice using the same tools and equipment that are common in the field.

You’ll perform case studies on a computer using mock charts and sample insurance forms so nothing will seem new or unusual on your first day at work. It’s a confidence booster.

Seasoned Instructors

There’s a distinct advantage to learning from industry-seasoned instructors. Most have worked their way through the ranks and have a thorough understanding of the field. They’ve been there and can tell you how to get ahead.

Most vocational school professors have years of experience under their belts, and many are still working in the field. Impressing them by working hard and you may earn a job reference.

Career Services

Medical billing and coding specialists are in demand, but why settle for any position when vocational school career advisers can help you find your dream job? There’s no guarantee, but they work hard to match graduates with good employers. Some schools offer lifetime placement benefits, an ace in the hole when the job market is tough.

Certification Preparation

Becoming certified in any field is the best way to demonstrate your professional accomplishments. Vocational schools help medical billing and coding students prepare for the exam by “teaching to the test.” Certification is an important step forward in your career.

Final Thoughts

Whether you have an aptitude for finance or research, you’ll thrive in a medical billing and coding career. Let a vocational school show you how.

Did learning about medical office protocol of a medical billing specialist interest you? Ready to attend Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical billing and coding specialist.

The post What is the Difference Between Medical Biller and Medical Coder? appeared first on Meridian College.

What Does a Medical Assistant Do?

Medical assistants manage clinical and administrative tasks in doctor’s offices, hospitals, clinics, and other medical facilities. It’s an exciting, blended role in which no two days are ever the same. Job responsibilities include:

Managing Phone Calls

Medical assistants are trained to recognize worrisome symptoms. When patients call with physical complaints, they collect data for the doctor, flagging urgent concerns. They also connect with patients before surgical or diagnostic procedures to review instructions and post-procedure care.

Rooming Patients

Medical assistants greet patients upon arrival and get them settled in exam rooms before the physician comes in. They review demographic information, verifying medication and allergy lists, so the doctor has the most up-to-date information with which to make clinical decisions.

Taking Vital Signs

As a medical assistant, you’ll take patients’ weight and vital signs at each visit, changing trends can be a risk factor for disease. Dosages for many medications, from antibiotics to antihypertensives, are based on weight, heart rate or blood pressure, so accuracy is essential.

Running Diagnostic Tests

Many diagnostics that were once done only in hospitals can now be performed by medical assistants in physician’s offices. Vocational school programs prepare students to do a range of tests with limited supervision, from EKGs to pacemaker checks, so doctors get immediate results, it’s convenient for patients and a more efficient use of resources.

Phlebotomy

Medical assistants are trained to draw blood from veins, collecting samples for tests. It’s a technical task that requires people skills and sound clinical judgment.

Giving Injections

Medical assistants are allowed to give intramuscular, subcutaneous, and intradermal injections in most states, using them to administer medications, including vaccines, and perform tuberculosis testing.

Billing and Coding

Most doctor’s offices use practice management software to track inventory so that supplies used during care can be billed to the right patient. Medical assistants ensure accurate reimbursement by properly coding documentation to reflect the services rendered.

Patient Education

Medical assistants serve as liaisons for the healthcare team. Valuable sources of information, they help doctors and nurses get the word out on timely health topics from medication safety to immunizations.

What Does a Medical Biller Do?

Medical billers have a non-clinical role managing administrative tasks related to billing, health insurance claims and financial reporting. The work is predictable yet never dull. Their responsibilities including:

Filing Insurance Claims

A medical biller files insurance claims, reviews charts and does the necessary research, so companies get the data they need to make quick coverage decisions. Being detail-oriented is a plus.

Medical Coding

Most healthcare bills in America are paid for by insurers, but companies require enormous volumes of information to determine if patients’ policies cover their bills. When completing claims forms, medical billers reduce the amount of data being transferred by condensing pages of facts into short, alphanumeric codes that describe everything from health conditions to medical supplies. Codes are also used internally and by healthcare watchdogs to track financial and health outcomes.

Requesting Insurance Preapprovals

Most elective healthcare services require preapproval, it’s a simple way for patients and healthcare facilities to avoid unexpected bills. Policies can be confusing, so it’s not unusual for patients not to know what they do and don’t cover. Medical billers work with insurers in advance to ensure services are reimbursable, helping patients and doctors make better treatment decisions.

Troubleshooting Rejected Claims

Some health insurance claims are denied for reasons ranging from insufficient data to transcription errors on claim forms. Medical billers review rejections, amending and resubmitting claims for timely reimbursement. Cash flow is vital to keeping the lights on in medical facilities.

Light Accounting

Medical billers track payments from the time services are provided until the final payment is made. Healthcare billing is complicated. Transactions typically require several adjustments, beginning with negotiated discounts, the amount doctors are paid by contract for seeing an insurer’s policyholders. Coinsurance payments made at the time of a visit are deducted while payments from insurance companies, sometimes more than one, must be verified and reconciled. Interest, late fees, and collection costs on overdue balances may also be applicable.

Billers may also be asked to perform a range of accounting tasks in the context of their role, from reconciling credit card payments to complimenting financial reports.

What Are the Major Differences Between a Medical Assistant and a Medical Biller?

Medical assisting and medical billing are similar in many ways. Both are flexible, future-forward careers offering regular hours and advancement opportunities. Each is backed by a professional organization that works to improve the field, continuing education is encouraged. Both work in similar settings, although medical billers may work in offices where health services are not provided. And at the end of the day, each contributes to the wellness of patients and the community.

But while the roles overlap in some areas, there are also clear differences. Medical billers have no clinical responsibilities. They get a brief primer on anatomy, physiology, and medical terminology in school so they can understand the language in health records. Their job is purely administrative but still requires some contact with patients and clinical staff, everyone in healthcare works on the same team.

Medical assistants are trained to manage both clerical and clinical duties, but their education in billing and coding isn’t as intense. Their clinical skills would be wasted in an all-administrative job, so they receive just enough training to help bridge the gap between the medical and business aspects of medicine. The role requires a close therapeutic relationship with patients.

What’s the Best Way to Become a Medical Assistant or Medical Biller?

Healthcare is a complex, highly regulated industry in which employers are held liable for the performance of their staff. Few private practices or medical facilities have the resources to provide the same level of training on the job as a vocational school can offer, so why take a chance on unqualified applicants?

Higher education in this industry is a must, but is it necessary to spend years in college? Training is never wasted, but the truth is, people with diplomas qualify for the same jobs in a fraction of the time. If you’re an adult with responsibilities and can’t afford to be without a job for two or four years, don’t put your aspirations on the back burner. Consider enrolling in a vocational school.

What Are the Benefits of a Vocational School Diploma?

There are many benefits to getting a vocational school diploma. From a comprehensive education to learning from industry seasoned instructors, if you are ready to start a new career than a vocational school can help.

Benefit #1: Get a Comprehensive Education

A college degree has long been the gold standard for education, yet vocational schools deliver the same high-quality training in less time by teaching practical skills. By focusing on what matters and eliminating electives that don’t improve job performance, you graduate in months, not years.

Benefit #2: Learn from Industry-Seasoned Instructors

Instructors who’ve worked in the healthcare industry have a deeper perspective on the medical assisting and medical billing fields. They’ve risen through the ranks, gathering knowledge along the way. Few people are better able to help you develop your career than those who have been there. Many are still in the business and can offer networking tips.

Benefit #3: Relax in Small Classes

People who haven’t been in school for a while may be intimidated by an impersonal learning environment. Being a number in a packed lecture hall is no one’s idea of education.

But vocational schools offer the small class sizes proven to enhance learning. Students get individualized attention from instructors, and they can better interact with peers. It’s a more creative, interactive process with immediate feedback, no one gets left behind.

Benefit #4: Learn Hands-on

Hands-on classroom exercises may be among the most effective ways for adults to learn. Recall improves and students process more material in fewer sessions. Vocational school programs use more than books to teach.

Medical billing students practice the most common procedures using the same type of software most doctor’s offices use. Medical assisting students learn how to take vital signs and perform diagnostic tests on state-of-the-art equipment. Graduates are ready to hit the ground running their first day on the job.

Benefit #5: Prepare for Certification Exams

Getting certified as a medical biller or medical assistant is an important step in a graduate’s career. It demonstrates proven skills and dedication to the field, impressing prospective employers and opening doors to opportunity. Vocational school programs cover the material on the certification exams and support students as they study.

Benefit #6: Enjoy Job Placement Services

Vocational schools excel at finding jobs for their graduates, their success as institutions depends on their placement rates. By working with local employers to meet their staffing needs, they become a crucial source of well-qualified medical billers and medical assistants. Graduates have the first crack at jobs the public rarely sees.

Benefit #7: Make Your Resume Shine

Training staff is expensive, and turnover is even more costly, so employers like hiring people who are committed to their field. Getting a diploma shows you care about your skills and your profession. As a new graduate competing with experienced applicants for the best positions, a diploma shines. It could be the difference between getting a job and your dream career.

Final Thoughts

There are many career options in the healthcare field, but few are as rewarding, secure and lifestyle friendly as medical billing and medical assisting. A better future working in a respected, flourishing industry is within your reach with a vocational school education. Why wait to pursue your dreams?

Medical Assistant

Interested in learning more about becoming a medical assistant? Meridian College offers hands–on Medical Assistant training from experienced school faculty who know how to prepare you for the daily challenges you’ll face on the job. From assisting doctors with patients to important administrative tasks, our experienced Medical Assistant program teachers will train you for a rewarding new career.

Medical Insurance Billing & Coding Program

Ready to attend Medical Insurance Billing & Coding program at Meridian College? Medical Billing and Coding professionals are responsible for keeping the records, charts, and bills in a medical office in order. In addition to the classroom experiences, students will also complete an externship for on-the-job training that will bring them further expertise. Contact us to learn more about.

Contact Meridian College today to learn more about becoming a medical assistant or medical billing and coding specialist.

The post What is the Difference Between Medical Assistants and Medical Billers? appeared first on Meridian College.