A Medicare biller works in a hospital or doctor’s office and submits claims to Medicare on behalf of patients. This job is similar to any other medical billing job in that the biller is in charge of entering accurate information and diagnosis codes on various forms that are sent to insurance companies. In order to properly submit bills and receive payment, a Medicare biller, on the other hand, must have a deeper understanding of specific Medicare codes and laws.
A high school diploma or GED is generally not required for a Medicare biller, though some larger offices may require an associate’s degree or certificate from a vocational school in a related field, such as medical office management. When a new employee is hired, they are usually given training. Excellent computer skills, comfort working with online forms and electronic filing systems, and a strong attention to detail are required for someone who wants to work as a medical biller in an office. When working with medical insurance claim forms, an employee must always act ethically.
In comparison to a traditional insurance company, Medicare has more rules, regulations, and specific processes that must be followed. All of these regulations must be known and understood by a Medicare biller in order to properly submit claims and answer any questions from patients. Medicare billers in larger hospitals or offices may never interact with patients face to face, but billers in smaller doctor’s offices may need to help patients fill out claim forms or answer questions.
After completing and submitting claim forms correctly, a Medicare biller must follow up on other claims to ensure that they are being processed correctly. If more information is required, or if a claim is incorrect, the biller must provide the requested information or correct the claim. A biller in an office may be required to complete insurance claim forms for other companies, assist in the maintenance of a filing system, answer phones, and perform other office and administrative tasks as needed, in addition to working with Medicare billing.
Medicare billers, on the whole, work fairly regular full-time hours. Because the job is fast-paced and stressful, good time management is essential. A successful Medicare biller may advance to the position of office supervisor or billing department manager.