How to Be Orthopedic Medical Biller - Job Description, Skills, and Interview Questions

Nov 16, 2020 / 5 Minutes Read / By Albert

How to Become

Professional Organizations

FAQ

Links

The role of an Orthopedic Medical Biller is critical in ensuring timely and accurate payments for medical services. This is because they are responsible for verifying patient information, entering patient data into the system, submitting claims, and tracking payments. In addition, Orthopedic Medical Billers must stay up to date on insurance policies and regulations, and ensure that all coding is correct.

If any of these steps are not done correctly, it can lead to delays in payments, and even rejections of claims. Therefore, an Orthopedic Medical Biller must be highly organized and have a thorough knowledge of medical coding and reimbursement practices in order to successfully process claims and secure payments.

Steps How to Become

Obtain a high school diploma or GED. While a college degree is not necessary to become an orthopedic medical biller, a high school diploma or GED is required.
Complete an orthopedic medical billing program. Look for programs that are accredited by an accrediting body like the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).
Obtain certification as an orthopedic medical biller. The American Academy of Professional Coders (AAPC) offers certification for medical coders in a variety of specialties. To become certified as an orthopedic medical biller, you must pass the AAPC's Orthopedic Medical Coding exam.
Gain experience in the field. Many employers look for applicants with experience in the field. This can be gained through volunteer work or internships at local hospitals or clinics.
Apply for jobs as an orthopedic medical biller. Look for job postings in your local area and online. You may also want to contact local hospitals or clinics to inquire about available positions.

Staying ahead and competent in the field of Orthopedic Medical Billing requires constant learning and development. Professionals must stay informed on the latest coding, billing, and reimbursement trends, as well as any changes to applicable laws, regulations, and policies. they must develop strong relationships with insurance companies and healthcare providers to facilitate a smooth reimbursement process.

Finally, by utilizing the latest technology and software available for medical billing, professionals can increase their efficiency and accuracy, ensuring that all bills are processed quickly and accurately. By taking the initiative to stay informed, build relationships, and utilize technology, Orthopedic Medical Billers can remain ahead and competent in their field.

You may want to check Orthopedic Physical Therapist, Orthopedic Front Desk Receptionist, and Orthopedic Rehabilitation Technician for alternative.

Job Description

Enter and review patient demographic, insurance and medical information into the billing system
Submit claims and other documentation to insurance companies
Follow up with insurance companies for unpaid or rejected claims
Resolve any insurance-related issues, such as incorrect coding or incorrect payment amount
Monitor, track and follow up on denials, rejections and appeals from insurance companies
Prepare and submit reports to management on the status of claims
Utilize various billing software programs to improve work flow and accuracy
Stay current with all policies and regulations from insurers and federal agencies
Educate patients on their financial responsibility for services rendered
Maintain accurate records and files for all patient accounts

Skills and Competencies to Have

Knowledge of medical terminology and coding systems.
Understanding of orthopedic medical procedures.
Ability to properly file insurance claims.
Knowledge of billing and reimbursement procedures.
Ability to use a variety of medical billing software programs.
Excellent organizational and communication skills.
Ability to work with data entry and other office-related tasks.
Advanced knowledge of HIPAA regulations, billing and coding guidelines, and other applicable laws and regulations.
Ability to accurately enter patient information into an electronic billing system.
Attention to detail and accuracy in all tasks.

The most important skill for an Orthopedic Medical Biller is the ability to effectively process, code, and submit claims to insurance companies. This requires a thorough understanding of the complex medical billing process and the ability to accurately and efficiently enter information into the system. When done incorrectly, this can lead to costly delays in reimbursement and can even result in denied claims.

To avoid this, Orthopedic Medical Billers must be detail-oriented and have strong organizational and communication skills. They must also be knowledgeable about the various coding systems and regulations associated with medical billing in order to ensure accuracy and compliance. having the right skill set is essential for an Orthopedic Medical Biller to be successful in their role.

Orthopedic Physiologist, Orthopedic Equipment Technician, and Orthopedic Clinical Research Coordinator are related jobs you may like.

Frequent Interview Questions

What experience do you have with medical billing for Orthopedic Specialists?
How do you stay up-to-date on changes in the industry related to Orthopedic Medical Billing?
What strategies do you use to ensure accurate and timely claims submission?
Explain how you handle complicated insurance coding issues related to Orthopedic Medical Billing?
Describe how you handle appeals and denials of Orthopedic Medical claims?
How do you use technology to streamline the Orthopedic Medical Billing process?
What techniques do you use for collecting payments on unpaid Orthopedic Medical bills?
How do you maintain compliance with PHI, HIPAA and other relevant regulations in the Orthopedic Medical Billing field?
What processes do you have in place to ensure patient satisfaction with their payment experience?
What experience do you have with software such as MediSoft or NextGen for Orthopedic Medical Billing?

Common Tools in Industry

Practice Management System. This system is used to manage patient information, scheduling, billing, and other administrative tasks in the practice. (eg: Athenahealth)
Electronic Medical Records (EMR) System. This system stores patient medical records digitally and allows providers to access them from any location. (eg: Epic)
Medical Coding Software. This software helps medical billers assign codes to medical diagnoses and procedures for insurance billing purposes. (eg: ICD-10-CM Coding Software)
Claim Submission Software. This software helps medical billers submit claims to insurance payers and track payment statuses. (eg: Availity)
Appeals Tracking Software. This software helps medical billers track appeals for denied claims and manage their resolution. (eg: MediTrac)
Collections Tracking Software. This software helps medical billers track payments and collections from patients and insurance payers. (eg: CollectLogic)

Professional Organizations to Know

American Academy of Professional Coders (AAPC)
American Health Information Management Association (AHIMA)
Medical Group Management Association (MGMA)
American Medical Billing Association (AMBA)
National Association of Certified Medical Examiners (NACME)
American Association of Orthopaedic Executives (AAOE)
National Association of Orthopaedic Technologists (NAOT)
Coding and Reimbursement Committee (CRC)
Orthopaedic Coding and Compliance Alliance (OCCA)
National Alliance of Medical Auditing Specialists (NAMAS)

We also have Orthopedic Pharmacy Technician, Orthopedic Consultant, and Orthopedic Prosthetics Technician jobs reports.

Common Important Terms

Coding. The process of assigning medical codes to diagnoses and procedures.
ICD-10. The International Classification of Diseases, 10th Revision, a universal medical coding system.
HCPCS. The Healthcare Common Procedure Coding System, a medical coding system used to document medical, dental, and vision services and supplies.
CMS-1500 Form. A standard form used by healthcare providers to submit claims to Medicare and other third-party payers.
Reimbursement. The process of obtaining payment from health insurance companies for services rendered.
EOB. Explanation of Benefits, a document sent by the insurance carrier to the patient or provider detailing the payments made for a claim.
UB-04 Form. A standard form used by healthcare providers to submit institutional claims to Medicare and other third-party payers.
Co-payment. A payment made by the patient at the time of service.
HIPAA. Health Insurance Portability and Accountability Act, a law designed to protect the privacy and security of patient health information.
Clean Claims. Claims that have been filled out accurately and completely, with no errors or omissions.

Frequently Asked Questions

What is an Orthopedic Medical Biller?

An Orthopedic Medical Biller is a professional who specializes in submitting medical claims to insurance companies for orthopedic services. They are responsible for ensuring accurate and timely payment of claims, as well as ensuring that all necessary documentation is included with each claim.

What qualifications are needed to become an Orthopedic Medical Biller?

To become an Orthopedic Medical Biller, individuals typically need a high school diploma or equivalent, plus experience in medical billing and coding. Additionally, they may need to be certified by a recognized medical billing organization, such as the American Academy of Professional Coders (AAPC).

What tasks does an Orthopedic Medical Biller perform?

Orthopedic Medical Billers are responsible for submitting claims to insurance companies for orthopedic services and procedures. They must ensure that all documentation is included with each claim, verify insurance coverage, and respond to any questions or inquiries from insurance companies. Additionally, they may be responsible for monitoring payments and following up on unpaid claims.

How much does an Orthopedic Medical Biller make?

According to PayScale, the average salary for an Orthopedic Medical Biller is $38,482 per year. Salaries can vary based on experience, location, and other factors.

What are the benefits of working as an Orthopedic Medical Biller?

Working as an Orthopedic Medical Biller can offer individuals a variety of benefits. These include job security, flexible hours, job satisfaction, and the opportunity to work with a variety of different medical professionals. Additionally, working in this field can provide individuals with an understanding of the complexities of the healthcare system and an opportunity to make a positive impact on patients' lives.