Medical Billing
Medical Billing is the process of submitting and following up on claims to insurance companies to receive payment for healthcare services. It's a crucial bridge between healthcare providers and insurance companies, ensuring that medical practices get paid correctly for their services. Medical billers translate medical procedures and diagnoses into standardized codes that insurance companies understand. This role is often confused with Medical Coding, but while they're related, medical billing focuses specifically on the financial and insurance claim aspects of healthcare.
Examples in Resumes
Processed over 500 Medical Billing claims monthly with 98% acceptance rate
Managed Medical Billing and Coding operations for a 5-physician practice
Reduced Medical Billing rejection rates by 35% through improved verification procedures
Supervised a team of 3 Medical Billing specialists in a multi-specialty clinic
Typical job title: "Medical Billers"
Also try searching for:
Where to Find Medical Billers
Professional Associations
Job Boards
Online Communities
Example Interview Questions
Senior Level Questions
Q: How would you handle a situation where multiple claims are being consistently denied by an insurance provider?
Expected Answer: A senior medical biller should discuss systematic approach to analyzing patterns in denials, implementing corrective measures, training staff on proper procedures, and negotiating with insurance providers when necessary.
Q: Describe your experience with managing a billing department and implementing new billing software.
Expected Answer: Should demonstrate leadership experience, change management skills, understanding of software transition processes, and ability to train staff while maintaining regular billing operations.
Mid Level Questions
Q: What steps do you take to ensure clean claims submission?
Expected Answer: Should explain verification of insurance coverage, accurate patient information collection, proper code usage, and checking for common errors before submission.
Q: How do you handle claim denials and appeals?
Expected Answer: Should describe the process of identifying denial reasons, gathering necessary documentation, following appeal procedures, and maintaining follow-up timelines.
Junior Level Questions
Q: What is the difference between primary and secondary insurance?
Expected Answer: Should explain that primary insurance is billed first, while secondary insurance covers some or all of the remaining balance after the primary insurance has paid.
Q: What information is essential to verify before submitting a claim?
Expected Answer: Should list patient demographics, insurance information, procedure codes, diagnosis codes, and provider information as essential elements to verify.
Experience Level Indicators
Junior (0-2 years)
- Basic insurance verification
- Simple claim submission
- Understanding of common medical terms
- Basic computer skills and billing software use
Mid (2-5 years)
- Claims denial management
- Insurance appeal process
- Payment posting and reconciliation
- Patient collections handling
Senior (5+ years)
- Team management and training
- Complex claims resolution
- Revenue cycle optimization
- Policy and procedure development
Red Flags to Watch For
- No knowledge of HIPAA regulations
- Unfamiliarity with common insurance terms
- Poor attention to detail
- No experience with electronic health records or billing software
