In today’s healthcare environment, with the myriad insurance plans available, and the shadow of the Affordable Care Act looming over healthcare reimbursement, medical billing has become more important than ever. When you go to hire a medical billing specialist for your practice, make sure you have a person who knows how to get the optimal reimbursement. Here are a few things to look for.
The person should have experience billing different insurance programs, as well as Medicare and state insurance programs, and they should be familiar with the various forms and procedures that are used for billing.
The person should also have a firm grasp of medical terminology. Some practices will even test job candidates to assess their knowledge of medical terminology. And obviously, the person should be especially familiar with the terminology used at a specialized practice, such as cardiology, urology or neurology (as applicable).
Make sure the person is certified and that they participate in continuing education programs to stay current with the regulations and healthcare changes. You also need to find out how long it takes the person to process one day’s worth of claims. He should be billing within two days of the current day.
Knowledge of electronic health records.
A medical biller has to be knowledgeable on the use of electronic health records to perform their job. So, when interviewing the person, know what electronic record systems they have worked with, how they used the records, and what type of software they are familiar with, programs such as Epic or Medisoft.
It is important that a medical biller know how to work with insurance companies and how to deal with patients. They must know how to handle a situation such as a claim denial and have the wherewithal to know how to go about challenging it. The biller also must be able to have frank conversations with patients who are not keeping up with payment on their bills.
Some human resource experts recommend using behavioral interview questions on these topics to learn about the biller’s skills in these areas. For example, you can ask about how the person handled claims denials in the past, what kind of plan they used for working with denials, and how they dealt with recalcitrant patients in the past.
These are in a sense similar to people skills, but it focuses primarily on how well the person can express himself verbally and in writing. If he has to argue his case to an insurance representative or a patient, he needs to be articulate and persuasive. These skills should not be overlooked when you are searching for a medical biller.
If you are looking for qualified medical billing professionals for your practice, Team1Medical is the place to go. Over the past 20 years, Team1Medical Staffing has become one of the premier staffing agencies in the Greater Houston area because of our service, reliability and expertise. We have helped numerous medical practices find the top-notch people they need. We only provide the best, and our record shows it. Contact us today to see what we can offer you.