What is Medical Billing?

For a patient, visiting a doctor’s office or a hospital is usually a straightforward affair. He or she walks in, fills out paperwork, is seen by a physician, pays for the visit, and then walks out the door. On the surface, it’s an uncomplicated process. But once the patient pays their co-pay for the visit or their treatment, how does a physician’s office receive payment from the person’s insurance company? And how is that coordinated for the hundreds or thousands of people who visit a doctor’s office on a weekly basis? That’s the job of the medical insurance biller.

What Does a Medical Insurance Biller Do?

A medical insurance biller manages payments and submits claims to insurance companies. That means they often work with patients to establish payment plans, identify and resolve billing complaints, and follow up on delinquent accounts. A medical biller is a person who can balance customer service and the ability to understand medical invoices. In short, they ensure that their employer has received the appropriate payment for all services rendered.

Medical insurance billers work for hospitals, clinics, nursing homes, outpatient care centers, federal agencies, and other healthcare facilities. They typically work 40 hours a week, and some facilities may need their billers to work day or night shifts.

What Do I Need to Become a Medical Biller?

Technically, all you need is a high school diploma to take a certification exam from the American Medical Billing Association (AMBA). You can take these exams online, but before you do, it’s a good idea to have some knowledge of medical billing before you give it a shot. Luckily, the AMBA offers online medical billing courses that can help prepare you for the certification exam.

Although you can become a certified medical billing specialist with just a high school diploma, it’s recommended that you earn at least an associate degree. Having an associate degree improves your job prospects, better prepares you for certification, and can increase the amount of money you earn. These degrees are available online as well as at brick-and-mortar universities. An online degree is a great option for those who are already working full time because it allows you to focus on your course work when you have the time.

However, be wary of institutions that claim you can earn a medical billing degree in just a few short weeks because these are likely diploma mills. A diploma mill is an academic institution that provides a degree without the proper credentials. Some offer degrees for life experience, while others claim you can get a bachelor’s degree in one to two years. Fortunately, the Commission on Accreditation for Health Informatics and Information Management Education, an independent accreditation agency, has a database of approved schools, which you can find here.

A medical billing student will study medical terminology, billing software, math, anatomy and physiology, and medical coding classes. Medical billing and medical coding are usually paired together in associate, bachelor’s, and master’s degrees, which makes sense because medical billers need to understand medical coding.

How Much Does a Medical Biller Earn?

The average salary for a billing clerk working in a physician’s office is $33,580, according to the U.S. Bureau of Labor Statistics (BLS). However, keep in mind that your salary as a medical biller may vary from the average, depending on your employer, education level, and professional experience. Job prospects for medical billers are positive as well, in part because many institutions are switching to electronic databases. The BLS describes the job market as favorable because the need for billing clerks of all occupations, including medical billers, is expected to grow 19%, adding approximately 79,000 jobs into the field, by 2018.

What Are the Opportunities for Advancement?

Many schools offer bachelor’s and master’s degree programs in medical billing and coding, which you can take to further advance your skills. In addition to learning more about the profession, those who obtain a bachelor’s degree may also receive a salary boost, as bachelor’s degree holders are paid about $7,000 more a year than someone with just an associate degree, according to the American Academy of Professional Coders. A higher degree can also lead to a position of more authority, as a graduate of a master’s degree program may work as a health information manager, who ensures the accuracy of all patient records. Additionally, because a medical biller also has training in medical coding, they can also pursue the coding certification from the AAPC to further boost their resume.