Perot Systems shares its experience of having recruited and trained hundreds of BPO associates in this article on identifying the key traits of a good medical biller.

Even in an age where the organizations are investing heavily on technology to stay smarter, faster and agile to stay competitive, it's really the people who drive the result. Behind every successful company, there is a group of qualified and dedicated people – its employees!

Challenges in recruiting good billers

The Medical Billing industry, among other industries, has seen a surge in outsourcing of employee-centric processes. This need has risen through the shortage of qualified employees in most markets. Companies are looking for other alternatives to stay competitive, and in some cases, just to stay in business. Excluding direct costs such as salary and benefits, the cost of training & development and retention are proving to be prohibitive; as much as 20% of direct costs if an employee stays for a period of one year and much higher if a trainee quits within the first year of employment.

Companies tend to “bite the bullet” and invest in training, quality control and retention but here's the conundrum; the effort put into improving staff skills and knowledge are not necessarily directly proportionate to the value outcome. While a great Human Resources and Development program can churn out misfits, a mediocre program can deliver stars.

The inference: A company can create a good employee but stars are made in heaven!! Well…. but it does take certain qualities to be a great Medical Biller and a good recruitment plan should be capable of identifying them. So, what makes a “Great Medical Biller”?

Understanding medical billing from an employee point of view

The first step towards answering this is to outline what goes into Medical Billing. The underlying principles of all Medical Billing functions, may it be mailroom functions, coding, patient account registration, charge entry, payment posting or receivables & follow-up, are the same. Every part of the Medical Billing process is designed towards improving cash flow and reducing per-claims costs for a practice. This is achieved by collection of data in a given format, addition or modification of the data and passing it on to the next level of the claim cycle for further processing. Accuracy, thoroughness and timeliness are key factors at each stage of the process.

Even though the functions vary largely in nature and complexity, and the training, skill-sets and knowledge levels required are unique to each position, the approach across all theses functions and services remain the same. The reasons for this uniformity in approach lie in the similarity across functions and processes. Most of the complexity and resemblances revolve around the following facts:

• Interdependency among even seemingly far removed functions
• The sheer volume of the data and information used at each level
• The need for intimate knowledge of client, state and payer requirements
• Little control over operational exigencies such as volume fluctuation and low data collection/availability standards
• Broad and often ambiguous payer billing guidelines
• Operation bureaucracy due to stringent government regulations
• Limited training tools in the Medical Billing environment
• Repetitive nature of the work Due to these diverse factors that affect the nature of a Medical Biller's work, the position demands multi-facetted individuals with who are capable of applying their knowledge, skills and experience to the various situations they encounter during their daily job functions.

The ideal Biller would have the following characteristics:

	1. Strong career orientation: The individual should be career-oriented and have a long-term goal that is industry-specific. This in itself is motivation to learn, giving the individual the ability to fit into higher decision-making positions within the organization or industry therefore serving themselves and the organization.

2. Ability to view the “big-picture”: Individuals should understand the nature of the business beyond their individual responsibilities. This will give them the ability to step back and view their contribution to the whole, therefore allowing them to better serve their internal clients or the people who follow them in the process chain. For example, a coder should have the ability to view the impact of coding to the compliance, payment of the claim and also a clear understanding of how their work affects the next individual in the chain, the claims entry person.

3. Eye for details: As much as an individual is capable of viewing the macro-picture, they should have an eye for details within their areas of responsibility. It is not uncommon that subtleties make a difference to the payment of a claim and these should be picked up in the early stages of the process. The individual should be able to apply their training to everyday situations and pick out the inconsistencies. Detecting a missed modifier or an invalid ID format can make that difference to a practice's receivables.

4. Teamwork: The individual should be able to work in and contribute to the improvement of the team. Unreliable data, erratic guidelines and sporadic information requires that individuals work in tight cross-functional groups and contribute to each other's areas of responsibility to achieve a high success rate. Function-based teams such as Coding, Charge Entry, Payment Posting and Follow-up teams have to work with each other but also across various specialty and state specifics to contribute towards a mesh that provide for quality. This is a particularly important attribute in today's global service delivery model where individuals work with multinational and multi-cultural teams.

5. Communication: This is the most underestimated trait, especially in entry positions. It is very often considered that an entry staff does not need communication skills and the misconception goes as far as stating that poor communication contributes to better data entry staff as they will have a higher level of focus. This would work if the nature of entry involved character-to-character reproduction from one medium to another. Unfortunately, Medical Billing goes beyond that, requiring individuals to read, interpret and enter data in a unique format outline by a state, specialty, treatment or payer. This involves keeping track of dynamic information, digesting it and using it in specific situations as well as working in team environments for effective delivery of the individual's job function.

	6. Analytical and Decision-Making skills: This ability allows a Biller to work with limited data resources. This is a cross-functional requirement that demands the intellectual capacity and confidence to make educated decisions under various circumstances.

	7. Learning ability: The employee should have an interest and the capability to keep up with this ever-changing industry.

	8. Systematic: The individual needs to be organized and systematic to allow them to deal with the large bulk of information that they come across in their tenure as a Medical Biller. This also contributes to a higher level of memory retention.

	9. Self-motivated and committed: The employee needs to be able to drive him or herself to improvement. Since one of the factors of this industry is a repetitive and sometimes monotonous nature, employees should be able to drive themselves towards self-improvement with an eye on their long-term goal.

	10. Typing skills and basic computer orientation: These are basic requirements and contribute to productivity, quality and the ability to learn at a quick pace.

Again, having said that, a combination of the above characteristics and contribution from the organization make a great employee.

A good work environment, growth opportunity, challenging responsibilities, security, compensation and benefits are some of the factors that employees look for in a company and provision of these factors allow them to contribute at peak.