Author Topic: Qualifications of a Medical Biller  (Read 6658 times)

tallmanusa

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Qualifications of a Medical Biller
« on: November 16, 2012, 10:52:50 AM »
I had a web demo of Care Cloud, a web based PM and EHR systems.
It does almost everything. It is amazing what the system can do. I am sure there are other systems which can do the same.

1. It automatically creates an insurance form and submits them electronically. No Super bill. If there are two insurances it submits them simultaneously. It scrubs them before submitting.

2. It tracks the insurance claims.

3. According to them, 85% of the payments come with electronic EOB, and that number is increasing. About 15% you have to record manually.

All of that for 99 cents per encounter.

I am hiring medical billers to work from their homes.

What qualifications I should look for?

I tend to believe that they must be computer savvy, more than anything else. They should be willing to follow up, which is the main thing we do. If they know how to navigate the site, they will do well; conversely does not matter how much they know about billing, but if they can't navigate well, it is useless.

I saw very little knowledge of actual filling out the claims that is required, because the system automatically does that.

It is basically a technology based job.

PMRNC

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Re: Qualifications of a Medical Biller
« Reply #1 on: December 02, 2017, 12:21:36 PM »
First be advised ariseandshine is OUTSIDE the U.S. You should know that if you should contact them or reply.

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I am hiring medical billers to work from their homes.

I've been in this business a long time.. I've seen all systems, demo's and yes many look so great that it almost seems like you don't need experienced billers. However, that is NOT the case. Before you hire, I would make sure that you determine the work course of each person, are you going to classify them (IRS) as contractors, sub-contractors, employees? I would also urge you to make sure you have the proper insurance (E/O in place) if you decide to hire sub-contractors or other billing companies I would make sure they carry their own, but if you hire employees you should be responsible for carrying the insurance, supplying ALL equipment, setting hours, work, etc.. It would very benefificial to you to consult with a tax attorney and accountant before even beginning the hiring process. After that I would probably want 3-5 years experience for workers that will work from home, nothing less. I would probably want certifications that require the biller to keep up their certifications with CEU units will ensure that your billers stay educated. I might also initiate an employment test with some pertinent medical billing questions.  How will they handle Appeals? Do they know how to process adjustments, do they know the difference between a fee scheudule and U&C, do they know ERISA, and so on..

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I tend to believe that they must be computer savvy, more than anything else. They should be willing to follow up, which is the main thing we do. If they know how to navigate the site, they will do well; conversely does not matter how much they know about billing, but if they can't navigate well, it is useless.

I couldn't disagree with this MORE. I had a client who had an IT person who they hired to do billing part time. This person was completely computer savy, could write programs and more but had no clue about billing, cost the provider a LOT of money and they had to let them go. Computer skills while important would fall into the bottom 5 of top 10 things I would look for. Not too many computer savy people without medical billing experience know about ERISA or how to handle contract or fee schedule's.

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I saw very little knowledge of actual filling out the claims that is required, because the system automatically does that.

I'll never believe that of any PM system ever! Hopefully the vendor didn't sell you that line and that you understand the industry and what a false misconception that is. It's almost as bad as coders saying EHR is replacing coders.

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It is basically a technology based job.

Again, I wholeheartedly disagree...Medical billing, practice management requires extensive problem solving skills, COMPLETE understanding of health insurance regulations, Federal and state regulations, that technology falls to the BOTTOM of the barrel on this. I'd rather hire a biller with experience in billing, health insurance regulations, HIPAA, ERISA, appeals, etc and know nothing about computer technology.. Hell I just call tech support if something don't work, it's their job.. NOT mine.

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Qualifications of a Medical Biller
« Reply #2 on: December 04, 2017, 08:18:20 AM »
DITTO

This is the craziest explanation of medical billing I have heard.
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