Job Description: Medical Billing Specialist

Medical Billing Specialist Job Duties | Medical Billing Specialist Schools | Medical Billing Specialist Salary | Medical Billing Specialist Pros and Cons

JOB RESPONSIBILITIES OF A BILLING SPECIALIST

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The healthcare industry is experiencing higher than normal growth, and the demand is very high for individuals to fill roles in operations, billing, coding and preparation of insurance claims forms. Medical billing is easily considered one of the hot healthcare information fields that can be combined with medical coding. The American Medical Association reports that there are approximately 1.2 million people employed as medical specialists across the United States of America.

A medical billing assistant is tasked with compiling, processing and maintaining patient medical records in a clinic or hospital. The medical billing assistant role is part of a broader category of Medical Records and Health Information Technicians. Medical assistants need to be skilled in understanding the complexities of insurance billing. This is one of the reasons for pushing the demand for medical billing specialists to an all time high, on the list of most popular careers in the U.S.

What Are The Job Duties Of A Medical Billing Specialist

· Assume responsibility for the submission of claims forms to insurance companies, Medicaid and Medicare
· Perform services related to securing payment from insurance companies and patients
· Retrieve and provide patients’ medical records to physicians, technicians and medical personnel
· Ensure strict confidentiality is maintained with regard to patients’ medical records
· Review records for accuracy, completeness and compliance with stipulated regulations
· Process documentation for patients’ admissions and discharges
· Plan, develop and maintain an indexing system for the storage and retrieval of patients’ medical records
· Compile patients’ medical records for the purpose of documenting health conditions and corresponding treatments
· Provide data as required for the purposes of care improvement efforts, cost control or data research
· Transcription of patients’ medical reports from the attending physicians’ voice recorded reports
· Preparation and processing of business and government forms
· Locate information about disease processes by consulting classification manuals
· Prepare medical census and healthcare data for statistical reports dealing with diseases treated, surgeries performed or use of hospital beds
· Create computer databases of information relating to history and extent of diseases, diagnostic procedures, demographic characteristics and treatments
· Efficient use of classification systems for identifying, abstracting, compiling and coding patient data
· Supervise clerical workers in the medical records department through direction and control of their activities
· Resolve conflicts arising from unclear or missing information through consultation with doctors
· Participate in the coding teams meetings on a regular basis
· Post patients’ medical insurance billings

Medical billing specialist need to be detail oriented and accurate. Errors will cause delay in payment and unhappy clients. Medical billing specials require knowledge of medical terminology, speech recognition skills, communication skills, computer literacy skills, comprehension skills, math skills, data entry skills, administrative skills and supervisory skills.

What Type of Degree is Needed To Be A Medical Billing Specialist

Medical billing specialists require a high school diploma or general educational development (GED) diplomas as the pre-requisite for further education and training for this role. A strong background in English language skills and typewriting skills is beneficial.

Anyone interested in a medical billing specialist career can gain the skills and knowledge necessary to the job through a certificate program. This will also form the foundation for further education in the future.

The medical billing specialist certificate program (referred to as medical insurance or medical billing and coding), is available from several accredited institutions across the country. The program covers the basics in medical claims processing such as ICD (International Classification of Diseases), CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) coding. The course prepares the student for certification from a professional organization.

The medical billing specialist program covers medical terminology and basic medical training, data entry basics, health information management fundamentals, human anatomy and physiology and software applications. The average course completion time is 80 hours.

Professional certification follows the graduation style of formal training and requires passing a certification exam. The certification is provided by a professional institution, valid for a period of one year. Certification needs to be renewed on expiry of the validity. Licensing is different from certification; it is required by state government agencies to demonstrate the student’s minimum levels of knowledge, skills and ability as required by law.

Certification as a medical billing specialist has several benefits that include: giving the individual an edge over the competition in the job market; demonstration of commitment to the profession; enhanced earning potential; demonstration of knowledge and skills; improved opportunities for career advancement.

The medical billing certificate program (CMRS) offered by the American Medical Billing Association (AMBA) is one of the most recognized in the field of medical billing. The association offers the Certified Medical Reimbursement Specialist exam, a certification that will help the student demonstrate knowledge of medical terminology, insurance reimbursement procedures, claims appeals, coding and compliance with HIPAA (America's Health Insurance Portability And Accountability Act) and OIG (Office of the Inspector General).

The CMRS program is divided into 16 sections with 700 questions in total. A passing percentage of 85 percent is required to receive certification.

Medical billing specialist courses include: medical terminology, introduction to medical billing, computerized medical billing, physician office billing and advanced computerized medical billing.

Continuing education and certification opportunities for professionals in the medical billing field are available. The American Health Information Management Association (AHIMA) offers a variety of courses including Registered Health Information Administrator, Registered Health Information Technician, Certified Coding Specialist, Certified Coding Associate, Certified Helath Data Analyst and Certified in Healthcare Privacy and Security.

What Is The Salary Of A Medical Billing Specialist

On the job front, its good news all the way to the bank for medical billing specialists! The employment market for medical billing specialists in hospitals and private clinics continues to grow. The demand is high for this career opportunity and is not limited to clinics and hospitals. Jobs are available in other healthcare facilities, medical billing companies, consumer billing advocates, insurance companies, local, state and federal agencies related to this field, and liability and malpractice companies in advisory positions.

The U.S. Bureau of Labor Statistics predicts a growth rate of 20 percent for medical records and health information technicians, which includes medical billing specialists, for the period 2008 to 2018. In 2009, the mean on average salary for medical billing specialists was approximately $33,880.

As the healthcare industry seeks more efficient ways to prevent billing oversights, costly errors and collect timely payments, the demand for medical billing specialists continues to grow.

The U.S. Department of Labor Occupation Outlook Handbook 2010-2011, lists the closest classification for a medical billing specialist as the Medical Records and Health Information Technician. The salary data provided states that medical billing specialists earn on average between $22,133 and $48,120. This provides a median salary of $33,880.
Wages

Medical Billing Specialist Wages

The average hourly rate for a medical billing specialist ranges between $10.5 and $18.5; the hourly overtime rate for a medical billing specialist ranges between $14 and $27.50. National annualized data shows that the bonus for a medical billing specialist ranges between $100 and $2,055 approximately. Overall annual pay scales range between $22,122 and $40,806 for a medical billing specialist.

Salaries for medical billing specialists vary based on the employer. For example, average pay scales by employer show: hospitals - $35,870; Physician offices - $28,460; Federal Government agencies - $45,120; Nursing care facilities - $33,100.

The larger employers like hospitals pay more on average that a medical billing specialist would earn in a physician’s office. Benefits are also expected to be comparatively better in the larger establishments than in the smaller ones. It should be noted that the larger establishments have stringent rules regarding medical billing specialist education and certification requirements. The government has significantly fewer employment opportunities for medical billing specialists and the majority of job concentration is in areas like Washington D.C.

The salary for a medical billing specialist is influenced by various factors including location, years of experience, education and certification levels and size of the establishment. When considering a job offer, it is important to factor in benefits such as holidays, vacation time, sick leave, time off, medical, dental and retirement savings plans (401k).

(Figures are approximate and have been rounded off to the nearest full number)

What Are The Pros And Cons Of Being A Medical Billing Specialist

In every job there are advantages and disadvantages; the same holds good for medical billing specialists. The advantages include:

· Career options for a medical billing specialist are not limited to clinics and hospitals, but extend to a number of other prospective employers like insurance companies, liability and malpractice companies and federal government agencies among others.
· The healthcare industry is continuously expanding and the demand for medical billing specialists is on the rise. The U.S. Bureau of Labor Statistics has predicted a 20 percent growth rate for Medical Records and Health Information Technicians, the closest to the medical billing specialist classification.
· With the right education and certification, doors of opportunity are opened to jobs offering very good pay scales and benefits
· Career advancement to supervisory and administrator levels is possible in this role
· Medical billing specialists enjoy flexibility in their occupation; many choose to work from home and others prefer to establish their own business rather than working for someone.

The downside to becoming a medical billing specialist may be attributed to the following negative aspects in the job:

· The medical billing specialist role requires 100 percent accuracy and attention to detail. It would be safe to say that there is no room for error in this profession. Errors can cause delays in payments, upset clients and even lose the company its unhappy clients.
· Physician documentation is not always as clear as it should be and often a medical billing specialist ends up going back and forth for clarification. This can be time consuming and frustrating.
· A medical billing specialist’s role is a stressful one because the individual has to be constantly alert to find errors and make accurate insurance claims.