What does a medical biller do day to day on the job?2 The specific duties, as well as the amount of time you would spend on these, will vary from one setting to another. That said, your occupational duties may include:

  • Obtaining referrals and pre-authorizations as required for procedures.
  • Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
  • Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
  • Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
  • Following up on unpaid claims within standard billing cycle timeframe.
  • Checking each insurance payment for accuracy and compliance with contract discount.

Requirements

Proficiency in the following areas is preferred:

  • Familiarity with CPT and ICD-10 Coding.
  • Must have EPIC experience
  • Competent use of computer systems, software, and 10 key calculators.
  • Effective communication abilities for phone contacts with insurance payers to resolve issues.
  • Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.