Practice Management Alert

4 must-have tips help you hire the best

Coding and billing experts agree that the cliche holds true: Good help is hard to find.
 
While it varies from office to office, most billing and coding positions require a combination of qualities that are difficult to find all in one person, says Maggie Mac, CMM, CPC, CMSCS, CCP, ICCE, an administrator at Bay Area Women's Care in Clearwater, Fla. For this reason, many practices that can afford to have split up duties among several positions to allow each employee to focus on what he does best, she adds. Still, all employees need to understand the basics: why patients owe money, how insurance works, how to read an explanation of benefits, what a deductible is, how to look up a CPT code, etc.

The best time to find out if a job candidate has the necessary skills and qualities is during the interview. Identify the most qualified applicant by incorporating these four tips into your interview process: 1. Review the resume of the applicant prior to his interview. Look for adequate qualifications, education and work experience, says Catherine Brink, CMM, CPC, president of HealthCare Resource Management Inc. in Spring Lake, N.J.

Also look for grammatical errors in the resume and other evidence of poor writing skills, Mac says. A biller has to be able to write effective appeals letters to insurance carriers and represent your practice in an intelligent way, she says. Writing skills are important. 2. Listen for good communication skills during the interview. Pay attention to how the applicant asserts herself and forms her sentences, Mac says. A biller needs to be able to communicate effectively with other office employees (to ensure billing runs smoothly), patients (who are often rude and difficult to deal with), and insurance companies (that are notoriously frustrating and tricky). A biller must be able to remain calm and mature when speaking with these various entities, Mac says. If the position involves collections calls and letters, the applicant must be an especially good listener, but also be firm and not allow patients to walk all over her, she adds. 3. Ask specific questions about the applicant's prior coding and billing experience. Have the applicant detail her past duties, especially in dealing with appeals, Mac says. You want to see if the applicant has real working knowledge of billing and coding, as well as how to investigate and appeal claims by proving medical necessity, fighting bundles, etc. Simple knowledge of how to print reports and send them isn't usually sufficient, she adds. Ask questions about specific billing scenarios to ascertain the applicant's level of expertise. For example, ask the applicant how she would handle a claim that was denied [...]