A medical billing expert is a professional who audits and submits financial claims. They are an essential part of the healthcare and medical industry. Billing experts communicate with insurance companies, medical professionals, and patients. The objective is to assist healthcare facilities to manage their financial aspects. This guide covers the duties and responsibilities of a billing professional.
Duties and Responsibilities of a Medical Billing Expert
A billing expert translates healthcare or medical services into claims. Then, they submit these claims to appropriate insurance companies. They also keep track of the status of medical claims to make sure that the healthcare or medical provider receives the payment in a timely manner. It is essential to run profitable practices. Without any doubt, a smooth billing process plays a critical role in the practice’s financial health.
However, the responsibilities and duties of a medical billing expert may be a little different if they also need to perform the coding task. Usually, billing experts perform the following tasks for the healthcare practice:
- Contact patients or insurance organizations for medical bills.
- Understand and clarify how insurance works.
- Communicate regularly with patients for obtaining insurance information.
- Help patients understand different financial choices and options.
- Keep track of unpaid claims.
- Review payment records and information.
- Get in touch with insurance companies for payment issues or discrepancies, if needed.
- Ensure that insurance payment is in compliance with the contract and is accurate.
- Research & appeal denied claims.
- Respond to all patient and insurance inquiries.
- Set up different payment plans for the patient.
- Handle billing software to submit insurance claims.
- Keep patient information confidential.
- And more.
Apart from the above-listed, there may also be some other duties that the billing expert may need to perform. They must also be fully updated on any change that may occur in the industry. It is also important for a medical billing expert to understand how to use the ICD-11.
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