What do Doctors Want in a Biller

[Danni R.]

<a href="http://www.youtube.com/watch?v=7GnoLJIIS4w" target="_blank">http://www.youtube.com/watch?v=7GnoLJIIS4w</a>

[Danni R.]

Right Steve, thank you for bringing this highly requested, often asked, and hotly debated question back into focus. This is true for any profession, whether they are medical billers, medical coders, medical assistants, nurses aides... you name it. While it is most critical to know what the educational and licensure requirements are in the state anyone wishes to practice their skill, and whether there are any regulations to obtain certifications or limited licenses (such as a limited x-ray licenses, or phlebotomy for those with blood drawing responsibilities, it is equally important to keep in mind that even if there are none, it is the EMPLOYER who sets their own standards when they hire.

And I do agree with Charlene. It is hard to land your 1st job immediately upon graduation. It's the same in the medical assisting profession. We get countless emails from new medical assisting graduates who have their diploma, degree, and/or past well known certification exams, yet, they state that they cannot land a job because employers want at least one year, if not two years of experience, rather than the credentials. They want to know how can they get experience if no one wants to hire them. We have discussed some ways of overcoming this catch 22; no experience, no job, no job, no experience dilemma.

Very, very important to know that there are ways.

[Steve Verno]

An employer is always free to set the standard for a potential employee.  That standard can be simple or that standard can be set high.  No matter, the person wishing to work for the employer must meet or exceed those standards that are set.  

A degree is never a guarantee that the person can do the job.  I met with a doctor earlier this week. His biller had a masters degree and was working on her doctorate.  His biller was his wife and had no clue what an ICD-9 or CPT was.  her attitude was, I have my degree, so I dont need anymore education.  her attitude was costing her husband a ton of money.  he had months of unpaid claims, a large demand of medical record requests and a stack of refund demands.  

His wife gave me a stack of medical records and asked me, "How would you code these?"  I returned them with a smile, and said, "With a trained, certified coder."  She gave me a nasty look and I replied, "You have the degree, so you should be able to code these, after all you say you dont need the education."  I then left without a further word.  In my head, I thought of the movie Airplane where Barbara Billingsly said, "Chump dont want the help, Chump dont get the help."  He's called several times in the past several days wanting another meeting.  Unfortunately, my schedule is full for the next several months.

Again, the bar is set, meet it or exceed it.  

[Pay_My_Claims]

My website states we only hire with 3 years of APPLIED billing experience. I had to put that up there to stop getting emails from grad students. Although I applaud them for getting their degree, like others they have to pay the dues and get in the door and gain the experience just as we all do.

[Danni R.]

Steve also said in previous posts, now buried deep in this forum; so, here it is one more time, to reiterate his invaluable words of wisdom:

Learn from the experts in the billing company. Don't let the ones who say we always do it this way if what they're doing is wrong sway you!  Watch out for the company know-it-none.  They're the ones who say, Hey!  I heard... or my friend says... or its illegal to.

Follow your training and do whats right.

Certification is not mandatory.  It is a personal or employer preference.

A degree is also not required.  It is a personal preference. If you wish to obtain a degree, you comply with the educational institution.

Some associations allow you to take a certification test.  Always check with the association beforehand.

If its been some time since you worked, a refresher course may be beneficial because of the many changes such as HIPAA, ERISA, TARF, COBRA, STARK and many more.  

Here's something to stick in your head til you're dead. If it ain't documented, it doesn't exist.

Always code to the highest specificity.

The ICD must support the CPT.

Last, verify, verify, and verify.

[Steve Verno]

Doctors today want someone with experience.

Why?

The person they hired may have said they had training and experience and knew the specialty.  As a result of the lies and deceipt to get the job by the untrained and inexperienced biller or coder, the practice lost money and may have been the target of audits and unreasonable refund demands.  So, the person may have been fired.  The provider cant affiord to go through what they went through again, so now comes along someone wanting a new career.  The doctor will not even consider the untrained and/or inexperienced person.  Even someone with training and experience is locked out due to the distruss.  Anyone looking for an interview may now be required to take a preemployment test.  If you pass, you may get the interview if you dont pass, no way will you get to meet anyone in the office.   

I speak from personal experience.  I was hired to replace a completely inept biller/coder.  With all my training, certifications and experience, I had to take three tests before being offered an interview.  The practice lost $500,000 in revenue.  They tracked down the biller who found employment with another doctor.  The practice sued her and she was ordered to pay the practice their $500K loss, administrative costs to determine their losses, court costs and attorney fees.  She was also sanctioned from State and Federal billing, so she lost her current job as well. The office manager that hired her also lost her job. 

You are in a catch 22 situation.  You dont have the experience demanded and because of your inexperience, you cant get hired to get the experience.  You may also be in a grographical area where it is oversaturated with no jobs in sight.  I recommend offering your services, as an intern to work the practice's accounts receivables for a 6 month period.  This allows you to gain some experience, show your success in recouping their money, and earning the trust of the doctor and staff.  Yes, there is no money, but it gets your foot in the door and it may open the way to a permanent job with pay. 

As a practice manager, I can tell you, that if I let you work in my practice, you better not make any mistakes and you will be under the microscope.  You will be watched like a hawk.   At my last job, I had to be running on my first day, once they agreed to let me work for them, even after three preemployment tests and a background check.  I had to do what i said I could do.  My many initials didnt mean diddly with them.  What they liked was getting checks in based on my work.  They hired three temps and 2 were fired on their first day.  The third quit.  She couldnt take the pressure of deadlines to get something done in 5-10 minutes.  Last, this is an unforgiving profession.  You cant complain.  YOu must do what you should do, based on your training and you must show results.  Do NOT try to convince them to allow you to work from home if that is your goal.  Have them trust you first and show them you can produce positive results.  It took me 6 years to be allowed to work from home.  I had to show not only how it would save them money and how it would make them money.  My first month at home I got a settlement from an insurance company for $250,000.  That earned me a $6,000 bonus. 

Good luck and much success.