Medical Billing Specialists (MBS) work in health care facilities, but unlike other allied health careers, the medical billing specialist works in the accounting department generating bills to insurance companies for reimbursement for insured patients. The MBS is also responsible for settling claims between health care facilities, insurance companies and patients. This can be stressful as often one party or another is going to challenge the claim. Generating bills is done through a computer system designed so health codes corresponding to a patient’s procedures and diagnosis can be determined. Because of this, the MBS must be aware of the insurance health codes such as ICD or International Classification of Diseases and CPT, Current Procedural terminology Code among others.
Medical Billing Specialist Job Duties
The MBS is responsible for collecting, posting and managing account payments. They are also responsible for submitting claims and following up with insurance companies. A brief sampling of duties include:
- Prepare, review and send patient statements
- Evaluates patient’s financial status and established budget payment plans. Reports status of delinquent accounts
- Reviews accounts for possible assignment and makes recommendations to the billing supervisor, also prepares information for the collection agency.
- Processes payments from insurance companies and prepares a daily deposit
- Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations.
Medical Billing Specialist Education
A certificate and/or degree are required for most medical billing specialist jobs. These can be attained from health specialty schools online or on-site in many community and private medical specialty colleges. Check out your community college for their programs or to find out if there are other accredited schools in your area offering either the certificate or degree. Possible online schools for you to look into are:
Coursework includes classes in medical terminology and procedures, insurance billing and coding on the ICD-9-CM, CPT-4, HCPCS coding systems and office administration.
Medical Billing Specialist Qualifications
Medical Billing Specialists must have a thorough knowledge of medical billing, be responsible, organized and detail oriented. They must have the intelligence and tact to work successfully with patients, employees and outside vendors, i.e. insurance companies and government agencies. While MBS is primarily an accounting position, it also involves much human contact, setting it apart from other types of accounting occupations.
For anyone interested in pursuing an accounting position, Medical Billing Specialist would serve those searching for a more varied and specialized position than the average accounts receivable or accounts payable clerk. They would also be working in a health care setting rather than a corporate one. Plus, they have more than the usual human interaction of most AR/AP employees. In summary, it is a specialized accounting career with lots of variety requiring specialized knowledge and constant re-education to keep up with the ongoing changes in both the medical and insurance fields.