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Basic Requirements For Medical Billing

The job of medical billing involves a lot of hard work and vast knowledge of medical terminology, anatomy, coding and proper completion of forms. In addition, you need to have basic computer knowledge and a typing speed of at least 35 words per minute. A good temperament is another important characteristic that the person needs to possess, since he is required to deal with a number of patients, their attendants, doctors, medical representatives and other office personnel.

Job Outlook And Employment Opportunities

Medical billing is one of the fastest growing careers in healthcare. The importance of medical billing personnel is on the rise, since several insurance companies and the government are continuously spending substantial time and money to nix fraud and abusive practices. Due to this demand, various companies and practices are constantly on the lookout for trained and experienced medical billers. Personnel could find positions with doctors, hospitals, nursing homes, insurance companies, legal offices, rehabilitation centers, legal offices and consulting firms or they could also work independently.

They could set up an electronic billing system through their personal computers. Independent medical billers can also work as insurance specialists and consultants. The job is lucrative and revolves around helping patients and medical professionals calculate their insurance bills.

Some of the other job opportunities that are included within medical billing are as follows:

- Billing Specialist

- Coding Specialist

- Medical Collector

- Patient Account Representative

- Claims Analyst

- Claims Processor

- Reimbursement Specialist

- Claims Reviewer

- Electronic Claims Processor

- Billing Coordinator

- Claims Assistant Professional

Work Culture

The work culture of medical billers is usually part of an office setup. More often than not, the personnel do not work in close proximity to where patients are diagnosed. They generally have billing offices and services in large corporate buildings, in small suburban offices and in the offices of doctors. They usually work during the day, from Monday to Friday, forty hours a week. However, there are times when, in insurance companies, they are required to work late at night. They are paid well for working overtime and their services are much appreciated by the medical establishment and patients alike.

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To the college I was just a salesman with a quota to fill. To me, I was a professional responsible for providing a high school senior, a drop out with a GED or a person “re-careering” with objective information to help them make a decision that could effect their life for quite some time. I wanted to do my part to help that person get the most out of the time and money they were willing to invest in themselves.

A common theme with many of the students I enrolled in the medical billing & coding program was an interest in a health care career without the “blood and guts” (a term I remember using to relax and get a smile from the student); or in other words the close contact with patients that would be experienced by a medical or dental assistant. For them, an administrative position like billing & coding was just what the doctor ordered (pun intended).

In this school, like many others, the medical billing & coding program was combined and came in two flavors: a nine month certificate program and an eighteen month degreed program. The difference? At the conclusion of the nine month program, the student received a certificate (not to be confused with a diploma) documenting their completion of the coursework.

The student was also prepped to take the American Health Information Management Association’s (AHIMA) Certified Coding Specialist (CCS) exam. Upon passing the exam, the student was awarded the CCS credential. At the conclusion of the eighteen month degreed program, the student would have earned an associate’s degree and, like the certificate program, would be prepped to take the CCS exam.

If I used any sales tactics it was to persuade the typical billing & coding student to enroll in the degreed program. By typical I mean a person with a high school diploma/GED and little to no practical work experience. The reason? Not because the school made more money (they did), but because I firmly believed – and still do – in education as the best way for someone to better themselves personally and professionally.

To me the certificate program was a strong second choice and usually selected by those students that, among other things, wanted to get in to the workforce faster or couldn’t afford the degreed program. As I mentioned earlier, upon graduation the student would receive a certificate stating that they completed the coursework and be prepped to take the CCS exam. To me the real value was taking and hopefully earning the CCS credential.

There are several credentials that can be earned by a medical billing and coding professional. Credentialing is a big deal. Why? Having those letters after you name (e.g. Jane Doe, CCS) proves that you have demonstrated the knowledge, skills and ability required to pass an exam issued by a nationally recognized American Medical Association (AMA) sanctioned organization. In the world of medical coding there are two organizations offering credentialing sanctioned by the AMA: AHIMA and the American Academy of Professional Coders (AAPC).

When you check out the AHIMA and AAPC websites – and I really hope that you do – you will notice that their credentialing programs are all about medical coding. You may have visited the websites of some allied health colleges and noticed that their medical billing & coding programs are really a bunch of medical coding classes with a couple of billing courses thrown in for good measure.

I think there are a couple of reasons why most curriculums focuses the bulk of their coursework on coding rather than billing:

:: Students are more “employable” with combined coding and billing skills
:: The health care industry is placing more value on coding skills
:: Medical billing can be learned on the job and requires little to no technical knowledge

I may repeat this in other posts but if you really are thinking about making the financial and personal commitment to a medical billing or a billing & coding program, I can’t stress enough the importance of performing your due diligence so you can make the quality decisions that will put you in the best possible position to be successful.

By due diligence I mean partnering with a parent, mentor or someone else you trust to be honest and objective to help guide you in your decision making process. You also need to be completely honest with yourself, know your strengths and weaknesses and apply that knowledge to your decision making process. For example, if you struggled in high school or have a learning disability you may not be able to pass the coursework and should consider other employment options. On the other hand if you were an outstanding student you might consider pursuing an undergraduate degree in health information management (see AHIMA.org for more information about a health information management program).

You should consult with the AHIMA and AAPC websites to see of there are schools near you on their approved list. I do know the AAPC also offers Internet-based or distance learning courses. If you are considering a program not approved by either organization then be sure to at least check out the school on the Better Business Bureau website and Google to see what previous students have to say.

Finally – and I’m probably get some hate mail – but please be very wary about any company offering medical billing correspondence courses and certificates. You will find out the certificates aren’t worth the paper they’re printed on when it comes time to find a job. Why? There is no AMA sanctioned body that issues medical billing certifications. The certificate is simply documentation showing that you took and passed some billing training program.

I can’t tell you how many times someone sent me a resume just because they had completed a medical billing correspondence course. I would not hire anyone with no prior experience. Why? I don’t want to train a newbie and can’t afford the liability exposure – someone not knowing what they’re doing can run off clients. I stick by this hiring policy after learning the hard way. Bottom line – no prior experience, no job.

Sources:

American Health Information Association (ww.AHIMA.org)

American Association of Professional Coders (ww.AAPC.com)

Also see:

“Billing and Posting Clerks and Machine Operators” Occupational Outlook Handbook 12 December 2007 http://ww.bls.gov/oco/ocos277.htm

“Medical Records and Health Information Technicians” Occupational Outlook Handbook 12 December 2007 http://ww.bls.gov/oco/ocos103.htm

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