Responsibilities of a Medical Biller:

1. Coding and Billing: Medical billers are responsible for accurately coding medical procedures and diagnoses using standardized coding systems such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD). They ensure that the codes reflect the services provided and comply with insurance requirements.

2. Insurance Claims: Medical billers prepare and submit insurance claims to various insurance companies on behalf of healthcare providers. They verify patient insurance coverage, gather necessary documentation, and follow up on claim status to ensure timely reimbursement.

3. Patient Billing: Medical billers generate and send invoices to patients for services rendered. They calculate the patient's portion of the bill, including deductibles, co-pays, and co-insurance. They also answer patient inquiries regarding billing and payment options.

4. Payment Processing: Medical billers receive and process payments from insurance companies and patients. They reconcile payments with invoices, identify discrepancies, and resolve any billing errors or discrepancies.

5. Medical Records Management: Medical billers maintain accurate and up-to-date patient records, including demographic information, insurance details, and billing records. They ensure the confidentiality and security of patient information in compliance with healthcare regulations.

6. Compliance: Medical billers adhere to legal and ethical standards related to medical billing and privacy regulations. They stay updated on changes in healthcare laws and regulations to ensure compliance in their billing practices.

7. Communication: Medical billers communicate with healthcare providers, insurance companies, and patients to resolve billing-related issues. They may negotiate payment arrangements, clarify coding or billing discrepancies, and provide explanations regarding insurance coverage and billing processes.

8. Financial Reporting: Medical billers generate financial reports related to billing activities, including revenue, outstanding balances, and accounts receivable. These reports help healthcare providers assess their financial performance and make informed business decisions.

9. Continuous Learning: Medical billers stay updated on industry trends, coding changes, and insurance policies through ongoing education and professional development. They may attend workshops, seminars, or webinars to enhance their knowledge and skills in medical billing practices.