Some people call working from home the new American dream, eclipsed only by the seemingly impossible dream of earning a passive income. Are work from home jobs limited to envelope stuffers and scams, or are there actually opportunities for people like medical billers and coders? You will find that, in the midst of the scams and fake job postings, there are real opportunities for work-from-home positions in the medical billing and coding field. But one of the biggest challenges that lies ahead of you is knowing where to look.
As a medical biller and coder, doctors, physicians and other healthcare providers rely on you to reimburse them for the services they provide to patients – not out of your own pocket, but by assigning codes to each service provided in order to create a bill, which is then sent to an insurance company of the patient herself. Although many medical billers and coders accomplish this by working alongside medical professionals in various healthcare settings, some do it in a more unusual (and for you, convenient) setting – their own homes.
The work of a medical coder and biller is not to be taken lightly. Mistakes can lead to incorrectly documented patient information, massive slowdowns in the healthcare process, and even lost reimbursement for the providers themselves. Before you decide to work from home as a medical biller and coder, ask yourself a few questions:
- Are you self-motivated? Can you complete difficult and complex tasks with no supervision and little direction?
- Do you have an eye for detail? Do mistakes infuriate you?
- Do you genuinely care about the healthcare industry? Would it bother you if your mistake resulted in a missed payment for a deserving healthcare provider?
- Are you prepared to study and train to learn the intricate process of medical billing and coding, an industry poorly understood by most?
Your job responsibilities will be numerous. As a medical biller and coder working from home, you’ll need to know how to do the following:
- Accurately assign codes based on the procedures, diagnoses and other services performed in hospital and/or physician’s clinic settings.
- Prepare paper and electronic claims and issue them to insurance companies, including Medicaid, Medicare, Great West, Humana, Blue Cross and Blue Shield, etc.
- Enter patient information into software installed on your computer.
- Post payments.
- Mail patients’ statements.
- Follow up on appeals, denials and unpaid insurance claims.
- Handle patient billing inquiries.
- Submit documentation to doctors and physicians.
- Seek payments from non-payers, such as by sending past-due statements and making phone calls.
The Knowledge You Need to Work From Home as a Medical Biller and Coder
There are two paths that lead to working from home as a medical biller and coder:
Education, typically defined as attending an online or offline college in order to obtain an associate’s degree in medical billing and coding or health information management.
Training, typically defined as attending an online or offline medical billing and coding training program offered by a professional organization or private company specializing in medical billing and coding training.
Both paths lead to certification, which, although not legally required, will go a great way towards convincing healthcare providers of your competence. Paul G. Hacket, the president of Stelo Medical Management, has written an acclaimed guide to starting a medical billing and coding business, and he’s deeply familiar with what it takes to succeed as a home-based coder and biller. Hacket estimates that up to 80% of medical billing and coding students choose the wrong courses. Regardless of the career route that you choose, your program should teach you the following topics (at a minimum):
- Medical terminology and human anatomy/physiology.
- The lifecycle of an insurance claim.
- The basic third party reimbursement and medical insurance claims process.
- Medical insurance forms.
- Procedural and diagnostic coding systems.
- ICD-9-CM, HCPCS Level II and CPT code sets.
- Medical office software.
Medical Billing and Coding Software
Perhaps the most important aspect of work-from-home medical billing and coding is choosing the right software. You’ll use medical billing and coding software every day to complete the majority of your tasks, regardless of whether you’re processing paper or electronic records. Although the software itself should be complex, its interface should not. Navigation should be complete with folder lists, menus, button bars and hot-key shortcuts. Instructional tutorials should be included. Customer service should be offered. The software should allow you interact using your mouse, not a text-only terminal.
Look for software with some of the following qualities and features:
Flexibility. The software should be highly customizable and scaleable, allowing you to handle as many claims as you wish. Grids should be adjustable according to fonts, colors, groups, shown fields and more. Line items should be selectable.
Automated billing. You should be able to simultaneously process print to file and paper claims, print according to date ranges and save batches for later reprinting.
Electronic claims support. The software should easily interface with electronic claims, not just paper claims requiring manual data entry. Even basic programs offer the ability to process individual and batch claims, and print images of CMS 1500 forms.
Detailed transaction views. You should be able to view payments and their associated charges, as well as charges and their associated payments.
Chart notes. The software should allow you to store RTF (rich text format) chart notes for each patient. Graphics, colors and fonts should all be easy to format. Charts should be easily searchable after you enter them through a word processor or built-in editor.
Financial reports. Features such as overall practice statistics, CPT code usage, insurance reimbursement and dynamic aging reports should come standard.
Tech support. The company offering the software should back up their product with friendly, helpful customer support in the form of email, phone, fax and/or live chat.
Free demo version. Some of the best medical billing and coding software programs are also available as free, limited-use demo versions that will give you an idea of what to expect from the retail package. If a demo isn’t available, the company should at least be willing to supply you with some screenshots or videos of the program in action.
Some of the companies offering medical coding and billing software offer to throw in a free list of healthcare providers that you can “count on” for steady work. This is an obvious red flag. Too often, these lists are heavily outdated, or offer the exact same information that you could find at the government’s official Medicare website.
Finding Work From Home Medical Billing and Coding Jobs
An education in medical billing and coding and the proper claims processing software are the two primary tools you’ll need to secure a work-at-home billing and coding job. The next step is to find an available position. You can start my browsing job sites, such as:
…as well as medical coding and billing forums, such as those offered by BC Advantage Magazine and the American Association of Professional Coders. Here, aspiring and working medical billers and coders describe how they’ve found work in the industry. Many of them actively work from home. If you’re lucky, you may even catch word of employment openings.
Don’t be discouraged by job postings that don’t specifically refer to at-home work. Most employers would prefer that you work in their physical offices. This doesn’t mean that you can’t convince them otherwise by showing off your credentials, knowledge and experience. Even if they don’t have an immediate opening, it pays to circulate your resume and make the healthcare community aware of your skills, especially considering the industry’s projected growth and the likelihood of more jobs becoming available in the future.
A Final Word
It’s entirely possible to start your career in medical billing and coding as a work-from-home employee. However, the most reliable way of working from home as a medical biller and coder is to do just the opposite, and start by working in an actual healthcare setting. Although you may be dead set on working from home and from home only, spending a year or even six months at a physician’s office or hospital and churning out impressive, accurate work could be all you need to convince your employer that you’re capable of billing and coding from home.
About our expert. Jan Jacobs has worked in medical offices since the early 1980's. Ms. Jacobs has worked for M.D.'s and D.O.'s in primary care and specialty care. She is employed as a senior medical biller and has been at her current job for nearly 10 years, where she uses three different billing systems.
