WHAT ARE THE RESPONSIBILITY OF MEDICAL BILLER AND CODER

Medical biller and coders have different responsibility to perform. We are vividly mentioned below that how medical biller and coders work:

A medical biller is responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid. It is a position that is critical for the financial cycle of all health care providers, from single-provider practices through large medical centers.




Medical biller is responsible for the timely submission of technical or professional medical claims to insurance companies. The position may be located in physician offices, hospitals, nursing homes, or other healthcare facilities.

  • 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.

  • Calling insurance companies regarding any discrepancy in payments if necessary.

BASIC REQUIRMENT OF MEDICAL BILLER:

Basic requirements typically listed include:

  • A high school diploma

  • Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred.

  • A minimum of one to three years of experience in a medical office setting.

Medical coders work for healthcare facilities where they convert patients' information to standardized codes, which are used on documentation for healthcare insurance claims and for databases. Medical coders assist practitioners to receive reimbursement from healthcare insurance companies.

Read more: Medical Billing And Coding Schools Los Angeles

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