9 Important Qualities of Great Medical Billing or Coding Specialist

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Medical Billing or Coding Specialist Qualities

Experts estimate that this field will grow by a whopping 11 percent rate from 2018 to 2028. It’s no surprise that getting paid in the healthcare industry timely is almost impossible. It takes at least one week to retrieve money from the payer. Additionally, refiling each denied claim costs an additional $25 to $118.

Firms also realize that about 90 percent of these denials are avoidable. Naturally, they’re keen to employ the right talent to avoid huge losses. We’re here to guide your recruiting team in making the right hiring decision.

Here are 9 Essential Skills Every Medical Biller Should Possess

Detail-Oriented

A skilled medical billing professional needs to have the ability to attend to every detail in the information recording process. The coder should ask the right questions and gather all the required data to handle claims well. They also need to proactively enter accurate data in the correct format to avoid confusion.

Furthermore, they should also make sure that they don’t skip any field while filing the claim with an insurance agency. With such data volume to deal with daily, medical billers/coders need to have a meticulous approach in every data entry.

Effective Communicator

It’s a common misconception that medical coders don’t converse with anyone at work. Skilled medical billers must possess excellent people skills that help them interact with critical people. Additionally, they need to be confrontational often to overcome various collection challenges. During these times, skilled professionals communicate their issues clearly and work with the person to collect payments quicker.

Also, in the face of adversity, they should be able to relax and focus on completing work as effectively as they can. They should act as a reasonable intermediary among the insurance company, healthcare institution, and the patient.

Active Listening Skills

One of the advantageous medical billing specialist skills is active listening. In this field, the new hire must be adept in listening and capturing information from healthcare professionals, insurance agents, and payers. Medical billers must listen to the healthcare personnel about the procedures and special considerations to bill for the right services. Having this quality also helps coders communicate productively with the insurance agents.

In a few cases, when the insurance agency denies a claim, the medical coder must try to understand the denial cause. It’s critical to extract the most information about denials to reprocess effectively. Active listening also helps while talking to the patients that have dues.

Read More: Best Practices in Medical Claims Processing

Technical Skills

While technical expertise is not necessary, medical coders need a basic understanding of coding software to carry out their functions properly. Electronic Health Records (EHR) are commonly used for various billing purposes. Being adept with handling these records is an integral part of their job description.

Additionally, familiarity with typing, Microsoft Office tools, and database management software also helps in the long run. The good news is these skills can be easily taught to new hires. Use an effective training program on the job to teach these skills and improve your employee’s technical skills.

Knowledge of the Human Body

Healthcare providers rely on their billers and coders to pass on patient information for insurance purposes. This data includes complex terms related to anatomy and physiology. Hence, it’s crucial for coders and billers to understand body structure and how it works to demystify these terms by themselves.

Clarity on these easily confused terms helps them process claims and payments quicker. More knowledge on these terms enables coders to assign codes to insurance claims efficiently.

Education and Certification

The medical coding and billing field is a highly responsible career choice. Hence, merely hiring a diploma or GED candidate may not be the ideal choice. During the hiring process, look for post-secondary career training in medical coding as a minimum qualification bar. A six-month certificate in the field is also a credible qualification.

However, hiring the candidate with a 2-year degree in this specific sphere could be your best pick. Some reputable certifications include Certified Coding Associate certificate by AHIMA or the Certified Professional Coder course by AAPC.

Strong Moral Character

Since coders directly bring in revenue, integrity is an absolute requirement to ensure they abide by strict ethical standards. They work with an organization’s confidential medical records daily and can easily misuse them. Hence, recruiters must look at the moral character as a job requirement to avoid any data leaking scenarios in the future.

Assessing integrity in a single interview is difficult for recruiters. So, insist on getting references to help understand the candidate’s abilities to refrain from misusing the data. Medical coders should treat patient data anonymously, avoid conflicts of interest, and adhere to strict coding standards to avoid legal action.

Problem-Solving Skills

Medical coders do more than just issuing bills. They should be able to combine their communication skills with their problem-solving abilities to tackle insurers and patients. Their main job should be to try their best to extract payments swiftly. A single-minded focus on solving the payment issue and succeeding in this pursuit defines the role.

With insurance companies, they need to file, process, and rework claims to facilitate payment. However, unlike insurance companies, many patients may not have money. In such cases, medical billers should cooperate with them to find the ideal payment plan that works for the patient and the organization.

Time Management Skills

Most medical coding jobs are relatively independent in nature. Though supervisors check on them from time to time, they don’t interfere much if the work is adequate and on-track. 

Since their work is volume-based, they have complete freedom over their tasks with minimal micromanagement. So, having the discipline and intention to manage time effectively is extremely valuable to medical coders.

Conclusion

Finding the right talent in this field will truly simplify your revenue collection. When you hire medical coders or billers, you trust them to handle confidential data. So, take your time and find the right fit for your organization.

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