Medical reimbursement specialists handle administrative tasks in healthcare settings, including patient record-keeping, billing, and insurance claims. They require strong communication skills and must be trained in medical coding and terminology. A degree and certification are typically required for entry-level positions.
A medical reimbursement specialist handles many important administrative tasks in a hospital or doctor’s office. He or she is responsible for keeping accurate records of patient information and ensuring bills are paid in a timely manner. Specialists also encode information about the patient’s diagnosis and submit formal claims for payment to insurance companies. For expensive bills, they work with patients to establish payment plans. The nature of the work requires professionals to be very detailed, organized and efficient in their work.
Health services can be hectic places to work. Doctors and nurses are constantly on the move, visiting patients and recording information in medical records. A medical reimbursement specialist collects charts and records completed by professionals and enters the data into a computer-based filing system.
A key responsibility of a medical reimbursement specialist is translating patient information into a standard encoding format. Encoding patient forms is important for accurately recording medical records and sending easy-to-understand reports to insurance companies. Most professionals are trained to code information according to Current Procedural Terminology (CPT) or International Classification of Diseases (ICD) regulations. After coding the bills, specialists review them to ensure their accuracy, save the documents and send copies to insurance providers.
Strong communication skills are important for a medical reimbursement specialist. A professional deals with patients, insurance company representatives and doctors on a daily basis. He or she often talks with patients face-to-face before leaving the office to collect copayments and establish payment plans. If the patient reports created by the physicians are not clear, the specialist should ask them to clarify points to ensure accurate records. Insurance representatives call or email the specialist if there is a discrepancy on a specific bill.
In most countries, an individual is required to earn at least an associate degree in medical coding or health information technology to enter the field. Courses are offered at many community colleges, universities, and specialized technical schools, and generally take about two years to complete. Students typically take courses in medical terminology, CPT and ICD form coding, human relations, and computer science.
Upon completion of an associate’s degree program, an individual can take a certification exam administered by a respected national organization to improve their chances of finding work. Organizations such as the American Health Information Management Association in the United States provide new professionals with the necessary credentials to work in hospitals, clinics, psychiatric wards and private practices. With experience and continuing education, a medical reimbursement specialist may have the chance to become a manager.
Protect your devices with Threat Protection by NordVPN
