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Back to the blogAug 24, 2021

6 Qualities That Make a Good Medical Billing Specialist

6 Qualities That Make a Good Medical Billing Specialist

Your practice’s financial health depends on hiring and retaining highly effective medical billing specialists. This growing back-office position helps ensure your practice gets paid on time for the services your providers perform. A knowledgeable medical biller will help you improve your billing practices and reduce denied claims, saving you time and money.

Here are six key qualities that make a good medical billing specialist.

1. The Medical Biller Should Have an Eye for Detail

A good medical billing specialist must be detail-oriented. Even minor errors in coding and billing can cause delays in payment or denied claims. Medical billers must be able to spot typos and other errors before they submit claims to payers. This preventive approach will save your practice time and money.

Many medical billing specialists are experts in coding. Besides submitting accurate claims, a detail-oriented specialist can help you identify common coding errors from your providers. They should be able to help build out a thorough claim edit library based on common denials to prevent dirty claims from going to the clearinghouse. They should also see if they can work with the EHR team to help configure the EHR appropriately so CPT & ICD codes come over accurately and never need to be modified. Through provider education and training, you can use common denials to improve coding and make revenue cycle groups more efficient.

2. The Medical Billing Specialist Should Be a Problem Solver

Claims denials are common in medical billing. While your practice can resubmit denied claims, the reasons for denial can be difficult to parse. According to one estimate, up to 65% of denied claims are never resubmitted. This is where a knowledgeable medical billing specialist can set your practice apart.

Reworking and resubmitting a denied claim requires strong problem-solving skills. The medical biller must determine the exact reason for claim denial, which may require returning to patients’ charts to search for coding errors. To reduce spending time on denied claims, your practice needs staff members who can rework the claim quickly but accurately and resubmit it in a timely manner.

A good medical billing specialist will also proactively work to solve insurance and coding errors before they submit medical claims. This requires coding expertise, a problem-solving attitude, and strong communication skills.

3. The Medical Billing Specialist Should Have Great Communication Skills

Though billers are back-office staff, they still need strong communication skills. When working claims, medical billers frequently have to call patients and payers for more information. This requires a courteous, professional communication style with a strong customer service skillset.

These critical staff members must also communicate effectively within your practice. For example, if they identify frequent coding errors, they must be able to communicate the problem clearly to clinicians and practice leadership. They also have to get more information from busy physicians. Medical billers with strong communication skills can be an excellent internal resource for training providers to document and code office visits more accurately. 

4. The Biller Should Be Able to Juggle Multiple Tasks Independently

Your practice sees many patients each day. Billing for each of these visits and tracking payment status requires multi-tasking. Medical billing specialists must be able to switch between tasks and types of tasks quickly to maximize their effectiveness. This requires independent prioritizing of tasks and an ability to recognize and react to urgent new priorities. Medical billers must also be able to handle interruptions, like calls from patients and payers, with ease.

In small practices, your medical billing specialist may also have other administrative or clinical duties. Multi-tasking and the ability to prioritize tasks independently are very important qualities for medical billers filling dual roles.  

5. The Medical Billing Specialist Should Be Comfortable with Technology

Most of a medical billing specialist’s work is computer-based. A good medical biller must be capable of working with your EHR to search medical records and your EPM system to bill for encounters and procedures. To keep your practice running smoothly, aim to hire a medical billing specialist who is already fluent in your EHR and EPM system, including both clinical and financial tools. For example, your medical billing specialist should be able to use the suite of tools included in NextGen’s Practice Management Billing Software to optimize your billing processes. 

Medical billing also requires an ability to work with multiple coding approaches. Different payers may require different billing approaches, making technical savvy important. Billing interfaces may also vary by payer. A strong medical billing specialist will learn new technical approaches quickly and be able to apply them consistently.

Finally, your medical billing specialist may also need to work with your accounting software, spreadsheets, or other software tools. This requires a staff member who is comfortable learning new programs and technical approaches. 

6. The Medical Billing Specialist Should Be Reliable

Medical billing specialists have access to private patient data as a routine part of their jobs. They must be able to keep this data confidential and comply with HIPAA and other relevant privacy rules. Medical billers also have access to extensive financial data about your practice. A good medical billing specialist will have the integrity and reliability to work with sensitive data without breaching patients’ or providers’ trust.

Your practice depends on consistent, timely reimbursement for the services your clinical staff provides. You need a medical billing specialist who keeps a consistent schedule and provides advanced notice of any absences. Small practices, in particular, may fall behind on critical billing tasks if a medical biller is frequently absent or late. Hiring a dependable medical billing specialist is an important part of keeping your practice’s finances in order.

How TempDev Can Help You Find the Right Medical Billers

TempDev’s developers, trainers, and consultants are NextGen EHR and EPM experts. Our consultants can help you review and improve your medical billing workflows. In addition, TempDev’s NextGen trainers can teach your medical billing specialists to use your NextGen system or upgrade more effectively.

TempDev also offers medical biller staff augmentation services to help you fill medical billing specialist vacancies immediately. TempDev’s NextGen medical billers can fill in while you hire permanent staff, cover a planned absence, or even support your medical billing needs long-term.

Call us at 888.TEMP.DEV or contact us here to get started finding the right medical billing specialist.


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