What You Need to Know About Running a Medical Billing Department

Do you have a passion for accounting and the medical field? Then you’re an ideal candidate for running a medical billing department at a clinic, hospital, or private practice.

Are you a current medical billing manager who wants to improve your department processes? Great managers are always looking for new ways to streamline the billing process.

Making such upgrades improves:

  • Office workflow
  • Patient experience
  • Insurer relationships

All three factors depend on accurate and timely medical billing. Take a closer at the industry to help refine your practices.

What Does a Medical Billing Department Do?

Medical billers are necessary for all health establishments. You’ll find them on-site at hospitals.

They also work at:

  • Local clinics
  • Private practices
  • Holistic centers (i.e., acupuncture offices)
  • Dentist offices
  • Urgent care centers

Establishments may also outsource their processes to other companies to help with the workload. If you’re interested in going into a medical billing career, there are plenty of niches to pursue.

Suppose you’re a medical billing department employee at a hospital. You would be responsible for the following duties:

  • Bill insurance companies for patient appointments
  • Process out-of-pocket payments for patients
  • Submit insurance claims for patients
  • Keep track of patient accounts
  • Communicate with patients about account balances
  • Manage inbound calls from patients
  • Update patient medical information
  • Implement payment plans for patients

Keeping accurate medical records is vital for this job role. That’s why technical abilities are an asset.

Employees must understand medical billing software inside and out. However, it’s also the department manager’s responsibility to update their office with the latest industry software.

Employees must understand medical codes associated with appointments. They need exemplary communication skills to regularly communicate with patients.

Billers oversee the communication of delinquent accounts. They also send unpaid accounts to collection agencies when needed.

Medical billers conduct regular document audits to ensure accuracy and streamline payments. They also ensure all processes are HIPAA-compliant.

Working With a Medical Billing Company

Do you run (or work for) a medical billing department at a major hospital? Large establishments have more responsibilities on their plates.

It’s common for large health companies to partner with medical billing companies to streamline processes. Managers must forge (and maintain) good relationships with these partners.

Partners like also specialize in revenue cycle management. RCM and medical billing go hand-in-hand. RCM monitors revenue per patient. You can’t track this data without medical billing.

Medical billing companies tailor processes to each health department.

Suppose you manage medical billing for a psychiatric department. You would need a partner that specializes in behavioral health billing.

There are also separate medical billing processes for:

  • Emergency services
  • Bloodwork labs
  • Surgeries
  • Anesthesia

Working for a medical billing company is another viable career path.

What Do Medical Billing Partners Do?

Medical billing partners offer a host of services. The first one is medical coding. Outsourced coders review insurance claims for processing.

Suppose you’re running a medical billing department at a hospital. Your in-house team doesn’t have to review claims themselves. They just have to send them off to the medical billing company.

This upgrade streamlines the process. Better streamlining reduces delays which improves the patient experience. You also save money on hiring by outsourcing medical coding.

One of the biggest challenges for medical billing departments is code compliance. Medical codes are updated regularly. Managers save money on compliance training by outsourcing claims work to certified coders.

RCM and Billing

Medical billing departments are responsible for tracking and processing payments. They’re central to RCM processes.

Revenue cycle management (RM) is critical for:

  • Hospital growth
  • Patient experience
  • Budgeting
  • Operational costs

This type of service relies heavily on analytics. Analysis reveals strengths and opportunities. Working with RCM partners helps optimize billing for maximum revenue.

Medical Bill Collections

Another challenge is handling delinquent patient accounts. Tracking down payments takes a lot of time. When you manage a hospital billing department, the pile mounts up quickly.

Working with an outside medical billing company takes the hassle out of this process. Simply transfer delinquent accounts to your billing partner. They’ll handle the entire collections process.

There’s also the challenge of claim denials. This process is time-consuming for in-house staff. However, you can outsource this entire step to a billing partner instead.

How to Become a Medical Biller

Are you interested in becoming a medical or hospital biller? Your first step is to choose a medical billing training program.

You can find programs at:

  • Local community colleges
  • Medical career colleges
  • Online schools

What’s important is that you find an industry-standard program. This career requires an acceptable certification.

You can earn a medical coder or biller certification to work in this industry. Earning a medical coder certificate also makes you eligible for coding jobs with medical billing partners.

Medical coders code patient charts, reports, and files. It’s their job to translate doctors’ reports into medical code. They send these documents off to medical billers for processing.

These roles fall under the “medical records specialist” BLS category. According to the Bureau of Labor Statistics, these professionals earn more than $46,000 a year on average. Job growth is also on par with the national average, which means there’s demand for these positions.

Medical billing department managers have the opportunity to earn even more. You would follow the same education track as a medical coder and biller. You would also need to supplement your education with hospital management training.

Managers are responsible for:

  • Hiring billing and coding specialists
  • Ordering department supplies
  • Implementing and upgrading billing software
  • Maintaining vendor relationships
  • Corresponding with insurance providers
  • Ensuring compliance
  • Overseeing hiring and onboarding
  • Department budgeting

You’re more likely to get a job as a department manager with a 4-year degree, as well. Look into healthcare management programs. However, business management degrees may also suffice.

Starting early in the medical industry also helps.

Kickstart Your Career In Medical Bills

There are several ways to break into the medical field without becoming a doctor. Consider the career possibilities of medical billing. Supplement your education and gain even more experience to start running a medical billing department.

Keep this guide on hand as you explore more careers. The blog is also packed with topics to inspire your journey.

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