The Dark Side of Hiring A Medical Biller

best medical billing company Providers looking to expand their practice or improve their revenue cycle are faced with one and the same dilemma: hiring an experienced medical biller. The hard truth is that hiring smart, experienced people for any role in your practice is a time-consuming task that has to be done correctly.

The low unemployment rate and the fact that some areas of the country never fully recovered from the Great Recession are just two factors contributing to hiring difficulties. Another problem is more specific to hiring billers: it’s extremely difficult to ascertain how capable a biller is before hiring him/her.

Coding and practice management credentials can help, but many practice managers have learned the hard way that there can be a huge disconnect between how a biller looks on paper and how they perform. Indeed, after hiring and letting go four billers in as many months, one Jacksonville, Fla. practice accumulated $900,000 in accounts receivable.

[PracticeSuite helps Jacksonville doctor clear up a $900k A/R backlog.]
Furthermore, the billers in your practice are susceptible to the same personnel issues as any other employee, including the tendency to leave your practice after you’ve invested heavily in their training, whether for personal reasons or because they’ve been offered a higher salary elsewhere.

Nevertheless, it’s imperative to apply a high standard to any biller you consider. They should have:

  1. Three to five years of experience (preferably in your specialty).
  2. Up-to-date knowledge of all current codes and industry best practices such as checking eligibility for the day’s visits before the day begins or making sure required prior authorization for treatments or procedures are obtained beforehand.
  3. A low rate of errors and omissions when filing claims
  4. An understanding of the most efficient way to follow up on claims
  5. An understanding of the most efficient way to handle denied claims
  6. An ability to organize their workload so priority items do not fall between the cracks.
  7. A bulldog tenacity that doesn’t shy away from perusing denials and filing appeals.

Remember that, in part, the amount of money your practice brings in depends on how competent your billers are. Compensating billing staff at or above the standard in your area is always a good idea, and consider incentivizing them with bonuses or other perks to daily follow up on claims.

Knowing When It’s Time To Outsource

Given all the challenges associated with finding, hiring, and retaining experienced, reliable billers, you may choose to consider outsourcing this critical work to revenue cycle management experts, which will be the topic of our next post.

Leave a Comment