Medical Billers have a behind-the-scenes but crucial role in the healthcare industry. Any time a person or insurance company receives an invoice for life-saving medical services, thank Medical Billers. Medical Billers send claims to insurance providers and individuals for services performed in medical settings, namely doctor’s offices, hospitals, and clinics. This job is crucial to the financial stability of the clinic and the relationships between providers and insurance companies. Funds that come in allow doctors to have the needed resources to treat the constant flow of patients. Both doctors and insurance companies honoring these payment arrangements keep working relationships healthy and can even translate to benefits for patients.
Medical Billing jobs go beyond sending a bill. This job involves curating all services for each patient’s visit, called a claim, and billing the correct insurance companies for the services performed. This process must be completed accurately and in a timely manner. Billers must be keenly aware of negotiated rates between insurance companies and providers to ensure they are charging the correct amount. In some cases, extensive follow up is needed to collect payments. Any disputes or discrepancies in the claim must be adjusted by the biller to expedite payment. Payments must then be tracked and allocated properly within the clinic and its service providers. Without properly managing this revenue cycle, clinics would fail financially.
This job has major benefits for patients as well. Billers go to bat on behalf of patients to ensure insurance companies are paying their fair share. Delays or failure to pay by the insurance company may result in patients receiving invoices for more than they are required to pay. When billers speak with insurance companies for payment, this eliminates the need for patients to negotiate difficult and confusing medical jargon. Payments are posted to the claim by the biller and updated as received, keeping patient records accurate. When patients are responsible for a balance, billers invoice and follow up with them to prevent collections and potential damage to their credit.
Medical Billing is highly specialized and allows doctors to treat patients without worrying about revenue. It plays an essential function in the healthcare industry and will always be needed.