What is a Medical Biller?
A medical biller handles the revenue cycle for healthcare providers, submitting insurance claims, posting payments, resolving denials, and managing patient billing. The goal is to ensure providers are paid accurately and quickly for services rendered.
In more detail
Medical billers work in hospitals, physician practices, billing companies, and remote staffing arrangements. Daily work includes coding charge capture review, claim submission through clearinghouses, AR follow-up on unpaid claims, denial management, and patient statement processing. Billers must know CPT and ICD-10 codes, payer rules, HIPAA, and the nuances of Medicare and commercial plans.
US BLS (SOC 43-9021, Billing and Posting Clerks) places median pay around $45,000-$55,000. Offshore medical billers through HIPAA-compliant managed providers typically cost $1,200-$2,000 per month with signed Business Associate Agreements.
Typical medical biller workflow
- Review charges and verify coding accuracy.
- Submit electronic claims through clearinghouses.
- Post ERA/EOB payments to patient accounts.
- Work denials and appeals within payer timelines.
- Run patient statements and manage collections.
Related terms
Common follow-up questions
No. Medical coders translate clinical documentation into CPT, ICD-10, and HCPCS codes. Medical billers take those codes and submit claims, manage AR, and work denials.
Yes, when the offshore provider signs a HIPAA Business Associate Agreement, implements required safeguards, and trains staff on PHI handling.
Common systems include Epic, Athenahealth, Kareo, AdvancedMD, eClinicalWorks, and DrChrono, along with clearinghouses like Waystar and Change Healthcare.