What Do Medical Billers Do?
Medical billers calculate health care provider charges, develop bills, and prepare them to be mailed to patients. By reviewing medical and hospital records and making or verifying calculations, they ensure that even the most complicated bills are accurate. Medical billers are responsible for timely submission of medical claims to insurance companies. Medical billers most often work with electronic billing systems and are responsible to make sure that patient, provider, and insurance information is correct and that fair payments are made. Medical billers may also be responsible for crediting patient accounts, appealing reimbursement denials, and tracking accounts receivables for providers.
Day-to-day responsibilities for medical billers will vary from location to location, but may include:
- Reviewing patient bills for accuracy and completeness and obtaining any missing information
- Knowledge of insurance guidelines, especially Medicare and state Medicaid
- Following up on unpaid claims within standard billing cycle timeframes
- Checking each insurance payment for accuracy
- Calling insurance companies regarding any discrepancy in payments, if necessary
- Identifying and billing secondary or tertiary insurances
- Making sure all accounts are reviewed for insurance or patient follow-up
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts
Where Do Medical Billers Work?
Medical billers work in a variety of health care settings, including hospitals, nursing homes, physician offices, skilled nursing facilities, home health agencies, and health clinics. Billing clerks are typically employed in an office environment, although a growing number—particularly medical billers—work from home or a separate office, either as independent contractors or with firms that specialize in medical billing.
Most billing clerks typically work 40 hours per week during regular business hours.
What Do Medical Billers Earn?
In 2022, the average annual income reported by the Bureau of Labor Statistics (BLS) for medical records specialists in the United States was $51,090. The New York State Department of Labor (NYSDOL) reports that, in 2023, medical records specialists in New York earned a median annual salary of $51,289 (medical records specialists in the 25th percentile made approximately $39,360 while those in the 75th percentile made approximately $66,614).
Supply and Demand
The medical billing occupation is expected to see strong growth in the health care industry as numerous recent state and federal reforms will make health care available to many more people. The Bureau of Labor Statistics projects that the number of jobs for medical records specialists in the U.S. will increase by 7% between 2021 and 2031. The New York State Department of Labor projects that the number of jobs for medical records specialists in the state will increase by 16% between 2020 and 2030.
For more information on projections of Billing and Posting Clerks by New York labor regions, 2018-2028, click here.
Education Requirements
Most jobs in this occupation require only a high school diploma; however, many employers prefer to hire workers who have a degree or have completed some college courses such as communication, accounting, and basic computer courses.
Medical billers can obtain training in a variety of ways, including on-the-job or through certificate or associate degree education programs and Web-based learning. Many community colleges and other colleges offer certificate programs in medical billing that generally take between two and three semesters and usually consist of courses in medical terminology, accounting, basic anatomy and physiology, and medical reimbursement methods.
Traditionally, billers have either been trained on-the-job or have been medical coders who do both the coding and billing. However, the shortage of coders and the growing demand for skilled medical billing specialists have employers looking for professionals who know billing basics.
New York Licensure Requirements
While New York does not require medical billers to be licensed or certified, national professional groups, such as the American Medical Billing Association, offer certified medical reimbursement specialist (CMRS) certification. Please visit AMBA’s website for more information: www.ambanet.net/AMBA.htm. In addition, the American Academy of Professional Coders, http://www.aapc.com/, also offers medical billers credentials based on passing a qualifying exam and experience and education.
Financial Support
It may be possible to obtain financial assistance for training and education from an employer. Also, colleges and organizations that provide training for those wishing to become medical billers may have scholarships.
Educational Programs in New York (subject to change)
Most jobs in this occupation require only a high school diploma, though many employers prefer workers with some billing, accounting, or customer service experience.
Information about education programs is offered by AMBA on their Web page “Medical Billing 101”: ambanet.net.
Many educational programs to become medical billers are offered online or on campus through BOCES schools, community colleges, and City University of New York (CUNY) schools, and State of New York (SUNY) colleges. Contact these agencies or search your geographic area online to find medical billing education programs convenient to you.
A sampling of education programs are listed below.
| Borough of Manhattan Community College-CUNY Center for Continuing Educ & Workforce Dev 25 Broadway, 8th FL New York, NY 10004 (212)346-8410 |
ABC Training Center 1 East Fordham Rd. 2nd floor Bronx, NY 10468 (718) 364-6700 |
| Berkeley College 3 E 43rd St & 12 E 41st St New York, NY 10017 (866) 317-6087 Also, campuses in Brooklyn & White Plains, NY |
College of Staten Island Office of Continuing Education 130 Merrill Ave Staten Island, NY 10314 (718) 982-2182 |
| Bryant & Stratton College Programs available at Albany, Amherst, Buffalo, Greece, Henrietta, Southtowns, Syracuse, and Liverpool campuses. (866) 948-0571 |
Schenectady County Community College 78 Washington Avenue Schenectady, NY 12305 (518) 381-1200 |
| Hostos Community College 500 Grand Concourse Bronx, NY 10451 (718) 518-4444 |
Hudson Valley Community College 80 Vandenburgh Ave. Troy, NY 12180 (518) 629-4822 |
| Hunter Business School 3601 Hempstead Turnpike Levittown, NY 11756 (516) 796-1000 or 3247 Route 112, Bldg # 3 Medford, NY 11763 (631) 736-7360 |
Westchester Community College 75 Grasslands Road Valhalla, NY, 10595 (914) 606-6661 |
| Branford Hall Career Institute 1100 North Broadway Amityville, NY 11701 (631) 608-9113 |
New York Medical Career Training Institute 36-09 Main Street, 5th floor Flushing, NY 11354 (718) 460-1717 or 500 8th Avenue, 5th floor (between 35th-36th Streets) New York, NY 10018 (212) 947-4444 |
| Plaza CollegeNew York Institute of Career Development118-33 Queens Blvd Forest Hills, NY 11375 (718) 505-4188 |
Kingsborough Community College2001 Oriental Boulevard Brooklyn, NY 11235-2398 (718) 368-5200 |
| Bronx Community College Workforce Dev & Continuing Educ 2155 University Ave Bronx, NY 10453 (718) 289-5170 |
Elmira Business Institute Langdon Plaza 303 N. Main Street Elmira, NY 14901 (607) 733-7177 or Vestal Executive Park 4100 Vestal Road Vestal, NY 13850 (607) 729-8915 |
| Ace Institute of Technology 312 W 36th St. 2nd Fl. New York, NY 10018 (212) 695-9700 or 4040 75th St., Ste. 4038 (718) 575-3223 |
ASA College Manhattan Campus Herald Center Mall 1293 Broadway (One Herald Center) New York, NY 10001 or Brooklyn Campus 81 Willoughby Street Brooklyn, NY 11201 (866) 990-6148 |
| Brooklyn Educational Opportunity Center Certificate Program 111 Livingston St. Brooklyn, NY 11201 (718) 802-3358 |
Queens Educational Opportunity Center Certicate Program 15829 Archer Ave. Jamaica, NY 11433 (718) 725-3320 |
| Hunter College 695 Park Ave New York, NY 10065 (212) 650-3850 |
Swedish Institute College of Health Sciences 226 West 26th St. New York, NY 10001 (212) 924-5900 ext. 199 |
| Lehman College 250 Bedford Park Blvd W Bronx, NY 10468 (718) 960-8000 |
LaGuardia Community College 31-10 Thomson Ave Long Island City, NY 11101 (718) 482-7244 |
| EBI Career College 4100 Vestal Rd. Vestal, NY 13850 (607) 729-8915 |
Queensborough Community College CUNY 222-05 56th Ave Bayside, NY 11364 (718) 631-6262 |