In this Article
By: Kendall Upton
Professional insights: Amy Jenkins
Medical billers are essentially what they sound like—they handle insurance claims and patient bills for healthcare organizations. It’s an important role under the large umbrella of healthcare administration, but you may be wondering just how much they interact with patients when it comes to their bills and finances. The answer really depends on the scope of your role.
What do medical billers do?
Medical billers are key members of the healthcare revenue cycle by overseeing claim processing. Their job is to make sure that insurance companies properly reimburse healthcare providers for their services and that any patient payments are processed accurately and on time. Typical job duties include:
- Create and submit reimbursement claims to insurance companies using diagnostic and treatment codes provided by medical coders.
- Review codes selected by medical coders to ensure they are accurate.
- Send invoices to patients for remaining balances after reimbursement payout, if applicable.
- Follow up with providers, insurance companies and/or patients to address any claim issues.
How much do medical billers interact with patients?
If you’re interested in a career as a medical biller, you may be curious as to how much patient interaction you can expect.
The short answer—it depends.
“The term ‘biller’ is really broad and can be used in different ways. As somebody who’s worked in the revenue cycle (I was a senior billing specialist, for example) I had no contact with patients,” said Amy Jenkins, Clinical Assistant Professor in Health Systems and Population Health at the University of Washington School of Public Health. “But you can have somebody working in patient accounts who’s also a biller, working with the patients and customer service, or working in financial services.”
Jenkins said that these types of customer service roles, often called a patient accounts representative, could involve a lot of patient interaction. For instance, they may have to follow up with patients about their claims if their insurance was billed incorrectly or the wrong insurance was billed. “You might have some interaction on the back end of that claim.”
In general, traditional medical billers may be more likely to interact with folks from insurance companies than patients.
“Oftentimes we’ll get claims submitted and there’s no response from the payer, or we get a denial and we’re not clear on why, so we have to go back to the payer to ask for clarity,” Jenkins said.
Similar roles
So what do you call someone whose role focuses on helping patients understand their insurance benefits, explain complex bills and discuss payment plans? These typically fall under a different job title.
“In the previous organization I was with, those were called financial counselors,” Jenkins said. If you’re someone who’s more interested in this kind of patient-facing position, a background in medical billing would be excellent experience to have if you wanted to transition to this type of role.
Why communication skills are important for medical billers
No matter how much or how little you interact with patients, strong communication skills are still absolutely key to your success as a medical biller:
- Collaboration with medical coders and healthcare providers: Medical billers may need to check in with medical coders or the providers themselves to ensure that the codes used in the insurance claims are accurate if discrepancies arise.
- Interaction with insurance companies: Billers regularly contact insurance representatives to verify coverage, resolve claim denials and follow up on delayed payments. Clear communication ensures accuracy and reduces processing time.
- Written correspondence: Billers prepare letters, appeal forms and email correspondence to insurance companies and patients. Writing clearly and professionally ensures requests and explanations are understood and taken seriously.
- Resolving disputes and appeals: When claims are denied or questioned, billers may explain the situation to patients or insurers, submit appeals and provide supporting documentation, all of which require strong written and verbal communication.
- Improve office workflow and accuracy: Medical billers act as a bridge between the front desk, providers and insurance payers. Miscommunication can result in delayed payments, denied claims or patient dissatisfaction. Strong communication ensures billing information is accurate from the start and reduces bottlenecks in the revenue cycle.
Key takeaways and closing thoughts
Medical billers ensure providers are reimbursed and patient payments are processed accurately. Their level of patient interaction can vary—some billers work mainly with insurers, while others take on customer service roles. Positions like financial counselors or patient accounts representatives typically focus more on helping patients understand their bills and payment options. Still, strong communication skills are essential to any time of medical billing role.
