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Understanding the Roles of a Medical Billing Specialist

By Edited Jul 27, 2016 0 1

The health care profession is riddled with individuals not only in patient care roles but in administrative roles as well. One of the most difficult but perhaps undervalued administrative roles is that of the medical billing specialist. These specialists spend a ton of time getting to know the intricate details of the health care field, from the procedures doctors order to the codes they are assigned by not only the medical community but the insurance companies as well.

The Start of the Billing Process

Medical payment specialists spend a ton of time working to make sure the facilities in which they work are paid properly while at the same time making sure patients are treated fairly. Their first role is to take the patient's file, convert treatments into code, and create billing statements. These statements are then mailed to insurance companies for payment. If a patient does not have insurance, he or she will be billed directly for medical services.

Medical invoice statements may be created manually but in many cases are now transmitted to the insurance companies via electronic means. These new systems make it necessary for administrative specialists to be familiar with a wide variety of different electronic systems.

Following Up on Invoices

Once invoices have aged past a certain number of days – usually 30, 60, or 90 – the medical billing staff must begin to follow up on payments that have not yet been received. They must make sure the statements were sent properly and did not contain any errors. Some may be lost and some may need to be resubmitted. If an insurance company denies a claim, the billing staff may attempt to adjust the coding to see if they can obtain payment. If not, they'll have to send an invoice to the patient.

Becoming a Medical Billing Specialist

You do not necessarily have to complete a special program in order to become a medical billing specialist. Some people start out in other roles and move into medical billing after receiving training from their employers. Others attend certificate programs at vocational or professional training schools. Some individuals opt to include math and medical training while working towards their Associate or Bachelor's degrees.

According to the Guide to Medical Billing, job opportunities in the field of medical billing are expected to continue to grow. The average medical billing specialist can expect to earn anywhere from $28,000 to $37,000 per year depending on education and geographic location.

The field of medical coding and billing is quickly growing and has the potential to offer rewarding job opportunities to those willing to put forth the effort. This is one career field that should not be ignored.




Sep 27, 2011 4:58am
Medical billing companies are very beneficial for the insurance companies and patients. Medical professionals manage all the data of patients and the expenses that they incur in their treatments. These data are very useful and save the time of insurance companies and patients at the time of claim reimbursement. There are lots of institutions that provide training and certification on medical billing. People who are looking for more information on medical billing schools can visit http://www.schoolformedicalbilling.com/
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