Medical Billing at a Glance: Part 1

My impression, based on conversations, emails, message boards, blogs and having actually been employed in the education sector, is most people interested in owning and operating a home-based medical billing service truly don’t understand the job of medical billing; the medical billing outsourcing industry and the rigors and requirements of owning a home-based business.

Although the FTC has litigated most of the major medical billing scammers out of business; their bogus sales pitches enticing unwitting victims with claims of easy number with no experience has seemed to persist. Over the past several years, there has been so much hype and discussion about medical billing as a work from home job opportunity that it has almost become the stuff of urban legend. Apparently everyone knows a friend of a friend that once met someone who somehow made a good living working in the medical billing industry.

Just Google "medical billing" and you will see a dizzying and confusing array of websites selling the work-at-home medical billing dream through training, education, software, books, website memberships, blogs and forums; and that doesn’t count the thousands of websites representing the actual medical billing businesses themselves.

I can understand why the casual observer could come to the conclusion that the demand for medical billing seems to outstrip the supply. An aging population fueling the increase in demand for entry-level allied health positions just adds to the hype. Is the projected growth in demand for health care professionals legitimate? Yes. Will this demand somehow affect your opportunity to own a medical billing business? That’s a complicated answer I will attempt to answer over the course of several articles.

My goal is to share my experiences and knowledge not only to provide the tips, tricks and how-to’s of owning and operating a home-based medical billing business; but more importantly to shed some light on the home-based medical billing industry in particular and the medical billing outsourcing industry in general. If I can provide any information that might help you to better invest your valuable time and money then I will consider my job done.

In that vein, I would be remiss if we didn’t first take a look at some of the more in-demand administrative positions in the health care industry – any of which could provide the foundation for someone interested in starting a home-based medical billing service.

Typically, when someone mentions medical billing they might be making a general reference to one of the following administrative health care positions: 1) medical billing clerk; 2) medical coder; 3) health information technician; and 4) health information manager.

Medical Billing Clerk

The medical billing clerk may be the job description that comes to most people’s mind when they think of the work-at-home medical biller or home-based medical billing service. The medical biller is responsible for ensuring the paperwork generated from patient treatments are entered in to a computer program; sent to the insurance companies in a timely manner and paid promptly to the provider of service.

The U.S. Department of Labor publishes a great resource called the Occupational Outlook Handbook. As an aside, I suggest using the OOH to get the scoop on any job or career you are seriously interested in pursuing. Following is a summary of how the OOH views the current and future state of the position of medical billing clerk:

::About 35 percent of these workers are employed in the health care industry.

::Most jobs in this occupation require only a high school diploma; however, many employers prefer to hire workers who have completed some college courses or a degree.

::Slower than average employment growth is expected as increased automation of billing services reduces the need for billing clerks.

Here is a real world employment ad recently posted on Monster.com for a medical biller:

"…position as medical biller with stable, well known, prestigious organization is hiring! Successful candidates will need at least 1 full year minimum experience in medical billing, verifying insurance and/or medical claims and must be able to deliver great customer service. Salary $11-$14/hour."

Based on the ad’s description, the individual will probably be performing several jobs - medical billing; verification of patient coverage and probably working the front desk. The fact that a physician’s office is more likely to hire someone cross trained to perform many of the office’s administrative functions makes sense; while a medical billing service is more likely open to hiring someone with only medical billing experience.

::Medical billing clerks do not work directly with patients

::Physician’s office or medical billing office will provide a professional working environment

::Work is performed at a desk and is not physical in nature

::Does not require a degree or certification; usually a high school education is sufficient

Cons:

::Demand for someone possessing only medical billing skills is anticipated to be weak

::Heavy computer and telephone work may lead to repetitive motion-related injuries

::Requires previous experience in most cases

::Employer may require additional schooling or training

::Employment opportunities will depend on geographic location

::One of the lower paying allied health positions; entry-level wages of $10/hour or less

Prerequisites:

::Knowledge of computer systems

::Strong keyboarding/typing skills

::Additional training or education may be required by the employer

::At least one year of experience

::Self starter with a can do attitude

::Strong organization, communication, problem solving and multi-tasking skills

I have oftentimes heard of former medical billing clerks starting their own medical billing services simply by convincing an employer to allow them to work from home. If medical billing is an opportunity you wish to pursue, check out all the resources you have at your disposal - online job boards (Monster.com, Careerbuilder.com, etc.), staffing agency websites, local hospital websites, newspaper ads, etc. - to verify job qualifications, starting salaries and overall job demand for medical billing professionals in your geographic location.

Please see the second article of this two point series in which I cover medical coding, health information technicians and health information managers.

Sources

Occupation Outlook Handbook: www.bls.com/oco
Monster.com