Medical Biller Job Description [Updated for 2025]

In the evolving healthcare sector, the significance of medical billers has never been more apparent.

As healthcare systems advance, the demand for proficient individuals who can manage, streamline, and safeguard our medical billing processes is mounting.

But let’s delve deeper: What’s genuinely expected from a medical biller?

Whether you are:

• A job seeker aiming to grasp the essentials of this role,
• A hiring manager outlining the perfect candidate,
• Or merely intrigued by the intricacies of medical billing,

You’re in the right place.

Today, we present a customizable medical biller job description template, designed for convenient posting on job boards or career sites.

Let’s dive right into it.

Medical Biller Duties and Responsibilities

Medical Billers play an essential role in healthcare operations, managing all aspects of patient billing, including claim processing, payment, and revenue generation.

They liaise between healthcare providers, patients, and insurance companies to ensure accurate and streamlined billing operations.

The primary duties and responsibilities of Medical Billers are:

• Review patient bills for accuracy and completeness and resolve any discrepancies
• Submit claims to insurance companies, ensuring each claim is accurate and complete for prompt payment
• Follow up on unpaid claims and disputed claims
• Check each insurance payment for accuracy and compliance with contract discount
• Communicate with insurance companies regarding any discrepancy in payments if necessary
• Identify and bill secondary or tertiary insurances
• Review accounts for insurance of patient follow-up
• Respond to inquiries from insurance companies, patients and providers
• Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
• Process patient statements, answer patient inquiries on account status and charges, and resolve issues as necessary
• Maintain patient confidentiality and adhere to health insurance portability and accountability act standards
• Keep informed of changes in billing regulations and procedures for all third party payers

 

Medical Biller Job Description Template

Job Brief

We are seeking a detailed-oriented, thorough, and organized medical biller to join our growing healthcare team.

In this position, you will play a key role in reviewing and analyzing medical billing and coding for processing.

You will review and accurately input procedure codes, treatment codes, and diagnostic codes into our billing software.

 

Responsibilities

• Translate patient information and into alphanumeric medical code
• Collect, post, and manage patient account payments
• Submit claims to insurance
• Prepare and review patient statements
• Review delinquent accounts and call for collection purposes
• Process payments from insurance companies
• Maintain strict confidentiality
• Code patient services and enter into billing software
• Check each insurance payment for accuracy and compliance
• Follow up on missed payments and resolve financial discrepancies

 

Qualifications

• Proven experience as medical biller or similar role
• Solid understanding of billing software and electronic medical records
• Must have the ability to multitask
• Thorough knowledge of billing procedures and insurance company procedures
• Proficient in MS Office (especially Excel); Working knowledge of relevant software (e.g. EMR) will be appreciated
• Excellent communication skills
• Problem-solving ability
• High school diploma; further education will be a plus

 

Benefits

• 401(k)
• Health insurance
• Dental insurance
• Retirement plan
• Paid time off
• Professional development opportunities

 

Additional Information

• Job Title: Medical Biller
• Work Environment: Office setting. This position is primarily desk-bound and in a controlled office environment
• Reporting Structure: Reports to the Billing Manager or Office Manager.
• Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
• Pay Range: $35,000 minimum to $55,000 maximum
• Location: [City, State] (specify the location or indicate if remote)
• Employment Type: Full-time
• Equal Opportunity Statement: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
• Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

 

What Does a Medical Biller Do?

Medical Billers are essential to the operations of healthcare facilities, such as hospitals, clinics, and physicians’ offices.

They are primarily responsible for the billing of services provided by healthcare providers to insurance companies.

They prepare, submit, and follow up on medical claims to ensure that healthcare providers receive payment for their services.

Their role involves reviewing patient records, calculating charges for procedures and treatments, and creating invoices, which are then sent to patients or insurance companies.

Medical Billers are also responsible for resolving any discrepancies or issues with claims by liaising with insurance companies.

They might handle any questions or complaints from patients about charges on their bills.

Additionally, they often work closely with medical coders to ensure that the correct codes are used for billing, thus requiring a deep understanding of medical terminology, health insurance policies, and healthcare laws and regulations.

In larger organizations, Medical Billers may specialize in specific areas, such as Medicaid or Medicare billing.

Regardless of their specific duties, all Medical Billers play a key role in ensuring the financial health of the healthcare provider they work for.

 

Medical Biller Qualifications and Skills

A competent Medical Biller should possess a blend of technical skills, soft skills, and industry knowledge to efficiently manage healthcare billing, which includes:

• Technical knowledge of medical coding systems and terminologies to accurately represent the diagnosis, procedures, and supplies used during patient care
• Understanding of healthcare regulations, including HIPAA laws and insurance policies, to ensure compliance in all billing operations
• Analytical skills to review, analyze, and validate patient billing data for accuracy and completeness
• Attention to detail to maintain accurate records and detect any discrepancies or inconsistencies in the medical billing process
• Proficiency in using medical billing software and electronic health record (EHR) systems to manage patient data, submit claims, and track payments
• Strong communication and interpersonal skills to effectively interact with healthcare providers, patients, and insurance companies
• Problem-solving skills to address any issues or disputes that arise in the billing process
• Ability to work under pressure and meet deadlines, ensuring timely submission and follow-up on insurance claims

 

Medical Biller Experience Requirements

Entry-level medical billers may have 1 to 2 years of experience, often obtained through an internship, part-time position, or certification program in the field of medical billing.

They can also gain valuable experience in roles such as a Medical Office Assistant, Medical Coding Specialist, or other administrative positions in a healthcare setting.

Candidates with 2 to 3 years of experience have likely worked full time in a medical office, hospital, or billing service.

These professionals often have a broader understanding of insurance processes, patient billing, and coding practices.

They might also have experience with electronic health record (EHR) systems and medical billing software.

Medical Billers with more than 5 years of experience often have a more advanced skill set, including expertise in medical coding systems like ICD-10 and CPT, as well as experience in handling insurance claims, denials, and appeals.

They may have taken on supervisory responsibilities and are typically qualified for managerial roles within a medical billing department.

Regardless of their level of experience, Medical Billers are expected to have a strong understanding of medical terminology, excellent attention to detail, and the ability to maintain patient confidentiality and adhere to healthcare regulations.

 

Medical Biller Education and Training Requirements

Medical Billers typically need to have a high school diploma or equivalent as a basic requirement.

Often, employers prefer candidates with a postsecondary certificate or associate’s degree in medical billing, healthcare administration or a related field.

This education provides a foundation in medical terminology, anatomy and physiology, and important legal and ethical issues related to healthcare.

Knowledge of billing software, medical codes, and insurance procedures is also critical for this role.

Therefore, training programs often include courses on these topics, equipping students with practical skills they will use on the job.

In addition to these educational requirements, many Medical Billers choose to become certified through organizations like the American Academy of Professional Coders (AAPC) or the American Medical Billing Association (AMBA).

These certifications demonstrate a high level of competency and commitment to the profession.

While not always required, some employers may prefer Medical Billers with work experience in a healthcare setting.

This experience can provide valuable insights into the day-to-day operations of a healthcare facility and the administrative tasks associated with patient care.

Ongoing training is also important in this field due to changes in healthcare regulations and insurance policies.

Therefore, Medical Billers should be committed to continuous learning and professional development.

 

Medical Biller Salary Expectations

A Medical Biller typically earns an average salary of $40,350 (USD) per year.

However, the actual salary may vary depending on factors such as the level of experience, qualifications, geographical location, and the healthcare facility where they are employed.

 

Medical Biller Job Description FAQs

What skills does a Medical Biller need?

Medical Billers should have a strong understanding of medical codes and terminology, as well as the various insurance plans and billing procedures.

They should also have excellent data entry skills, attention to detail, and proficiency in billing software.

Good communication skills are also important, as they often need to liaise with healthcare providers and insurance companies.

 

Do Medical Billers need a degree?

While a degree is not strictly necessary for a Medical Biller, many employers prefer candidates with an Associate’s degree or Certificate in Medical Billing or a related field.

Additionally, certification from an accredited body such as the American Academy of Professional Coders (AAPC) can make a candidate more desirable.

 

What should you look for in a Medical Biller’s resume?

Look for evidence of formal training in medical billing, either through a degree program or certification.

Familiarity with billing software and experience with data entry is also important.

Any experience in a healthcare setting or dealing with insurance companies can also be a plus.

 

What qualities make a good Medical Biller?

Good Medical Billers are precise and meticulous, as accuracy is crucial in the billing process.

They should also be ethical and trustworthy, as they often handle sensitive patient information.

Good organizational skills are also key, as Medical Billers often juggle multiple tasks and must keep track of a large volume of information.

 

Is it difficult to hire Medical Billers?

The difficulty in hiring Medical Billers may depend on your location and the specific requirements of your organization.

In general, there are many qualified Medical Billers, but the best candidates will have both formal training and practical experience.

It’s also important to find candidates who are a good fit for your organization’s culture and values.

 

Conclusion

And there you have it.

Today, we’ve uncovered the real essence of being a medical biller.

Surprise, surprise?

It’s not just about billing and coding.

It’s about creating a seamless healthcare experience, one claim at a time.

Equipped with our comprehensive medical biller job description template and practical examples, you’re ready to step up.

But why stop at the threshold?

Explore further with our job description generator. It’s your next stop for creating precise job listings or polishing your resume to perfection.

Keep in mind:

Every medical claim is a part of the bigger healthcare system.

Let’s streamline that system. Together.

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