How to hire an insurance biller
Insurance biller is one of several hats worn when running a successful group therapy practice. Practice owners are tasked with juggling everything from providing quality therapeutic services to managing administrative responsibilities. One role that requires careful attention to detail and expertise is insurance biller.
→ Click here to enroll in our free on-demand Insurance Billing for Therapists video course [Enroll Now]
Hiring a specific insurance biller role can benefit a group practice by improving its financial health and overall operations. It gives group practice owners time to focus on therapy and managing other operations. Hiring an insurance biller can also reduce the possibility of errors in insurance claims and form submissions that can jeopardize the practice receiving timely reimbursement for services.
Of course, it’s important to consider certain key areas when hiring an insurance biller. Assessing billing needs, defining the insurance biller’s role, and considering qualifications, experience, and technology proficiency are crucial. Join us as we dive into these points and more.
Assessing billing needs
Before you start the process of hiring an insurance biller, it’s important to assess what your practice’s billing needs are.
Here are some factors to consider:
- Volume of claims
- Insurance contracts
- Complexity of billing requirements
Consider evaluating your current billing system, including any potential areas of improvement.
Defining the role of a biller
Define the expectations and responsibilities associated with the insurance biller’s role clearly. Practice owners should establish a well defined job description. This can help to streamline the hiring process and set expectations for potential candidates.
Potential responsibilities of an insurance biller for your group practice may include:
- Creating and sending invoices to clients
- Managing insurance claims submissions
- Resolving denied claims (appealing/re-submitting claims as needed)
- Posting payments
Qualifications and skills
Seek an insurance biller who possesses qualifications such as a strong educational background and prior experience with medical billing.
Consider looking for candidates that demonstrate skills such as attention to detail, reliability, trustworthiness, and strong interpersonal skills. Successfully managing billing in a group therapy practice requires a combination of clear communication with others and the ability to competently complete necessary tasks.
Experience in mental health billing
While experience in medical billing is helpful, it can be invaluable for a candidate to have specific expertise in mental health billing. These candidates are likely to have a thorough understanding of specific insurance requirements, coding procedures for therapy services, and navigating complex reimbursement processes.
You may want to seek a candidate with prior experience resolving a range of billing-related issues specific to mental health practices. This familiarity can lead to improved accuracy of claims, timely reimbursement, and compliance with insurance standards. That in turn can positively impact the financial health and stability of the practice.
Technology proficiency
Hiring an insurance biller who is proficient in technology can enhance productivity and minimize errors. Candidates should be familiar with billing software and Electronic Health Record (EHR) systems commonly used within a group practice.
Knowing how to navigate an EHR allows the biller to efficiently and accurately identify information needed for accurate billing of services, such as ICD-10 codes for specific medical diagnoses. Using an EHR can help a practice identify missed or inaccurately billed charges.
Billing systems can be seamlessly integrated with other practice management tools, such as TheraPlatform. A skilled biller should be able to utilize these tools to coordinate several aspects of the practice, from documentation to financial organization and scheduling.
Start My Free Trial
Compliance and ethical considerations
When selecting a biller for your group therapy practice, it’s important to look for individuals who have a strong understanding of the importance of compliance and ethical considerations.
Candidates should be willing to adhere to regulations such as HIPAA in order to protect client privacy and make confidentiality a priority.
A biller should also demonstrate willingness to use ethical practices, ensuring accurate documentation, appropriate coding, and clear communication with patients and payers. This can help uphold the integrity of the practice.
Communication and interpersonal skills
A biller’s role will require frequent interactions with clients, insurance companies, and other health professionals. Billers should demonstrate the ability to clearly communicate with others and apply strong interpersonal skills.
Complex billing information may need to be obtained and relayed to providers, clients, and families. Therefore communication is key for this role.
Resource allocation and budgeting
Key components of an insurance biller’s job are resource allocation and budgeting. An insurance biller may be responsible for managing the practice’s financial resources. Through this, they can optimize the revenue generated and minimize expenses.
The insurance biller for a group practice should ensure that billing processes include timely and accurate invoicing as well as monitoring accounts. Part of the individual’s role will be to follow up with any outstanding payments or denials.
Hiring process
You may want to consider using multiple channels to attract candidates for the insurance biller position. Practice owners can post job openings on online job sites, utilize professional networks such as LinkedIn, and consider hiring a recruitment agency that specializes in healthcare staffing.
The hiring process may include performing screenings, reference checks, conducting interviews, and completing background checks in order to find the most qualified candidate.
Training and onboarding
After the candidate has been selected, it’s important to invest the time and resources needed in training and onboarding the insurance biller. The newly hired insurance biller should receive training on the practice’s billing processes and compliance protocols.
Training should also be provided on the practice’s software systems. TheraPlatform offers demos and support that can help insurance billers learn how to use the practice management software to automate claims, accept online payments, send payment reminders, and more.
Performance monitoring and evaluation
Once the biller is hired, their performance should be regularly monitored and evaluated for effectiveness in meeting specific standards.
Practice owners can set key performance indicators (KPIs) that may include metrics like claim submission rates, denial rates, and time elapsed between services and payments. Providing constructive feedback during performance evaluations can help support the insurance biller’s professional growth.
Team collaboration
A team collaboration model can support a culture of open communication and mutual support within a practice. This can in turn maximize productivity and create a positive environment for individuals to work.
You can foster this team model by encouraging collaboration between the insurance biller and the rest of the staff, including clinicians and administrative staff.
Troubleshooting and conflict resolution
Common billing challenges and errors should be addressed through clear protocols for resolution. Billers should be encouraged to use certain strategies for resolving billing discrepancies and disputes, such as prompt and efficient communication with payers.
Start 30-day Free Trial and explore TheraPlatform. HIPAA Compliant Video and Practice Management Software for Therapists.
Keeping up with industry changes
As the field of healthcare constantly evolves, billers should stay current on any changes in insurance policies, billing practices, or privacy regulations. One way to do this is by participating in continuing education opportunities (CEUs) and professional development courses or events.
Hiring a biller can benefit a group therapy practice by improving its success and efficiency. Efficient billing plays a critical role in ensuring the financial health of the practice.
When hiring a biller for a group therapy practice, it’s important to keep certain key points in mind. After assessing the practice’s billing needs, practice owners can seek a biller who possesses strong communication and interpersonal skills, is familiar with healthcare billing, and works well in a team environment.
Resources
TheraPlatform, an all-in-one EHR, practice management and teletherapy software was built for therapists to help them save time on admin tasks. They offer a 30-day risk-free trial with no credit card required and support different industries as well as different sizes of practices including group practices and solo practices.
More resources
- Therapy resources and worksheets
- Therapy private practice courses
- Ultimate teletherapy ebook
- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
Free video classes
- Free insurance billing 101 for therapists in private practice course
- Free mini video lessons to enhance your private practice
References
Burks K, Shields J, Evans J, Plumley J, Gerlach J, Flesher S (2022). A systematic review of outpatient billing practices. SAGE Open Medicine.10, DOI: 10.1177/20503121221099021
Jankelová, N., Joniaková, Z., & Procházková, K. (2022). The way to business competitiveness: the importance of diversity management and teamwork climate in stabilizing of employees. Journal of Business Economics and Management, 23(3), 606–625. https://doi.org/10.3846/jbem.2022.16199
Yadav, S. (2024). Transformative frontiers: a comprehensive review of emerging technologies in modern healthcare. Cureus, 16(3), DOI: https://assets.cureus.com/uploads/review_article/pdf/230344/20240320-3210-1l9dlkq.pdf
