Thursday, December 4, 2008

Medical Billing Careers

By Herbert Reich

Working in medical billing is one of the most important areas in the medical field. With exciting changes looming on the horizon of today's health care system it is critical to have knowledgeable professionals working on the same team as doctors, nurses, laboratory technicians, and other paraprofessionals. Everyone wants to get paid for what they do, and the biller is the one who makes that happen!

Typically the medical biller works for a health care provider and has responsibility for preparing and submitting claims to insurance companies. You must be precise and thorough in entering data into the computer. If this is the career choice that you make, you will be the one who answers questions, both over the phone and in person, from patients, clerical staff, and insurance companies. You will demonstrate your ability to use appropriate problem-solving techniques when confronted with complaints. Once insurance payments are received, you must efficiently record them as well as related adjustments. Whenever an insurance company fails to pay, it's the biller who figures out from obscure insurance company jargon just what action can be taken to get the maximum payable benefit. It's the biller who determines that if all possible insurance payments have been received, it's time to release the statement so the patient can pay the balance. It's the biller who has to be there to help the patient evaluate whether it's better to pay with a lump sum or a budget plan. Sometimes it is necessary to report and follow-up on delinquent accounts.

In the course of your work as a medical biller, you'll become familiar with medical jargon and find yourself recalling all of your college Greek and Latin (if you took them) in the form of all the prefixes and suffixes used in medical terminology. You'll gain a deeper understanding of human anatomy and learn the names of common diseases and disorders. Of course, there will be times when you need to look up information as well.

In preparing to process medical insurance paperwork, the biller needs to communicate effectively with the physician or lab technician who has performed a procedure. You will need to take the initiative to identify times when a patient is seeing a doctor for a one-time visit and possible follow-up, or whether the doctor wants you to bill a set fee for a series of visits for something like fracture care. You must be able to compare the patient's diagnosis with the procedure that was performed and make corrections if needed. For example, if the patient's last complaint was a cervical neck sprain and he is currently seen for a dog bite, the correct diagnosis must be identified on the insurance form to justify a tetanus shot. The biller becomes a master at decoding the doctor's illegible scrawling: was Benzaclin for acne ordered, or was it Benadryl for allergy?

Throughout all of these responsibilities, you have to develop the personality of a true diplomat. You are dealing with rushed and preoccupied doctors, and they will appreciate your ability to catch on quickly. You will enjoy professional interactions with other medical office staff and technicians. All of this knowledge is available to you through a medical billing course available at Ashworth College. You can step up to the challenge and step into a job in which you'll earn respect from your peers while you enjoy a good living. - 16003

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