Are Medical Billing From Home Jobs For Real?

by Lori

I heard a lot about working from home in medical billing. Is this a legitimate job or just a scam? If it’s legitimate what kind of training or experience do you have to have in medical billing and/or coding?

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Probably over half of the questions we receive on the website are about working from home in medical billing. Are these work from home jobs possible? Yes but it’s not as simple as some may lead you to believe.

Medical billing and coding is one of these occupations that’s been promoted as a good work from home candidate. I guess because it’s a back office support type job. However you do have to interact with the provider and their staff – it’s not a solitary job. There are also a lot of medical billing courses on offered on the internet that make claims about working from home.

The medical billing process is more complicated than many realize. Understanding the claim process, the different requirements of all the insurance companies a provider is contracted with and their unique guidelines, and knowing what to do when a claim is rejected is important. Only with experience can a medical billing specialist understand what it really takes to get claims paid.

How Are Home Medical Billing Jobs Possible?
There’s really only two ways to work from home in billing and/or coding:

  • Having an employer who allows it.
  • Owning your own medical billing or consulting company.

Working for a provider or employer who allows it.
There are many providers or employers who will allow you to work remotely. But you usually have to have a level of trust that you can work unsupervised. That means you probably have to work in their office for a while before they would consider allowing you to work from home. Once they have confidence in your abilities, they will probably be more open to working from home. Maybe only a day or two a week at first. Some larger employers are becoming more flexible in allowing employees to work from home. Technology and electronic documents are also making this easier and more secure.

Being a business owner or consultant.
Starting a home medical business is not for the faint of heart. Actually setting up an office and establishing a business is the easy part. The hard part is getting clients – especially if you have no experience in medical billing or coding.

I strongly recommend that anyone trying to work from home get some good training and experience first. A billing specialist needs to have a good understanding of CPT and ICD-9 codes, medical terms, insurance contracts (PPO, HMO, etc.), clearinghouses, coinsurance and deductibles, payment posting, and how to correct or appeal claims. There’s more detailed discussion on the billing process and all that kind of stuff on our medical billing specialist page.

It’s really difficult to convince a doctor or office manager to let you take over their billing if you haven’t done it before. A provider can’t afford to have their biller learn on the job because the billing process is fundamental to the financial income of the practice. You have to remember the livelihood of everyone working there is dependent on getting claims paid. If you haven’t done it before it can be overwhelming. Understanding the claim process, the unique differences and requirements of all the different insurance companies, knowing how to create and transmit claims, how to set up patients, compliance, etc.

The Challenges of Working From Home
You have to be self motivated and results oriented. And believe me that’s not always easy when working from home. When you have children and work from home, there’s always the potential for interruptions – especially young children. You have to establish boundaries. Medical billing and coding is something that’s detail oriented and takes your undivided attention. Being constantly interrupted or asked questions can really zap your productivity and frustrate you.

There’s also all the chores around the house that need attention – cleaning, laundry, feeding the kids, etc. When working from home you have to be able to compartmentalize your life – this takes discipline. Also the parents of your kids friends have to understand that just because you work from home doesn’t mean you’re always available to watch all the kids.

Working from home can also be hard on your mental health. When you don’t have the social interaction you otherwise have in a traditional workplace, it can affect your state of mind.

HIPAA and Patient Privacy
Another concern of medical billing from home jobs is compliance with HIPAA requirements for protecting the security and privacy of patient records. When you work in a provider’s office, the billing and coding functions are performed in an area off limits to the general public. And the area is secured after hours.

When you work at home, you have to make provisions to be HIPAA compliant and protect the privacy of the providers patients. Any medical records, encounter and financial information must be protected and secured per HIPAA requirements. This may take some investment and work to set up a home office that is compliant.

As mentioned earlier, technology and the ability to create and manage many documents electronically make working remotely more secure. Instead of having to haul around a bunch of paper documents and make sure they are secure, many of these can be accessed electronically which allows access control and an audit trail.

In summary – yes it’s possible to work from home in medical billing and coding. And the strong demand for medical billing and coding specialists make it a great career. However it does take a good knowledge in the field, a willing employer or client, and an ability to produce results for them. You will most likely need to spend time working in a provider’s office to gain the experience necessary to master the field.

We’ve got more detailed info on medical billing from home on our home billing jobs page.

Thanks for a great question!