What Is Medical Billing and Coding? - MedCerts

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You’ve seen the advertisements and heard about the industry. But you’re probably still unsure about what exactly medical coding and billing means, right?

Medical billing and coding is an important behind-the-scenes area of healthcare most people don’t think about.

It’s a specialized field that requires reading patient charts to figure out medical histories. It also requires training to learn important coding systems to properly file insurance claims as well. Based on patient charts, professionals use medical codes to write reports that are used by insurance companies and healthcare providers to submit claims for proper reimbursement.

In short, it’s a field that requires a high level of expertise due to its fast pace.

And, it involves a huge responsibility of handling the routing of a lot of money in the healthcare world.

Ready to learn more? Read on.

What is Medical Billing and Coding Exactly?

Medical billing and coding is a field in healthcare run by specialists who are responsible for the shape of a facility’s revenue cycle.

So, what does medical coding and billing consist of? A lot of paperwork.

When a patient comes in, a paper trail starts. Medical coders and billers pick up the end of that paper trail.

After a patient visit, a medical coder designates a specific code to the services the patient received. This may include the doctor’s visit, shots, x-rays, and any other additional testing a patient may go through during an appointment.

Every service must be documented properly — that’s the role of the coders.

These codes are taken from medical records, including lab and radiology notes, doctors’ notes, and more. It takes knowledge of medical terms to decipher the codes, which is learned during on-the-job training or through certification courses.

A medical biller and coder is responsible for assigning codes and organizing all information relating to claims. Billers and coders often check in with doctors and other staff to ensure proper diagnoses were documented.

Neither biller or coder has regular contact with patients.

Every claim is important, so it’s critical for healthcare facilities to have a biller and coder who is detail-oriented and quick to process the work. The financial health of most healthcare organizations largely falls on the thorough job medical billers and coders do.

Are Medical Billing and Coding the Same?

No. A medical coder reviews documents and uses code classification systems like CPT, International Classification of Diseases (ICD-10-CM), and HCPCS Level II. Medical billers work on claims to be sent to health insurance companies that need to be reimbursed for services provided by healthcare professionals like doctors.

You can be certified in both fields, though.

What to Expect as a Medical Biller and Coder

So, what is medical billing and coding like?

As a medical biller and coder, you can expect to be busy — a lot. Think of the last time you were in a doctor’s office, or even how long it took you to get an appointment scheduled.

Now think of all the paperwork in your file.

A medical biller and coder wades through all that information (confidentially, of course), to ensure everything is submitted in accordance to government regulations in a timely manner.

It’s an important job that takes a patient and organized person to handle.

Here are a few other things to expect as a medical biller and coder:

Office Setting

You’ll spend a lot of time in the office in front of a computer. Much of a medical biller and coder’s work is online. Most jobs can be found with insurance providers, law firms, healthcare contractors, doctors’ offices, and other medical facilities.

Fast-Paced Days

Every day you’ll process quite a bit of paperwork. You’ll need to know codes and regulations like the back of your hand to ensure timely submission of paperwork. Healthcare facilities want to see claims processed as quickly — and accurately — as possible to keep revenue streams coming in.

Collaborative Environment

Unless you work from home, you can expect to work alongside other healthcare office professionals. You’ll work with a team to get through the most pressing files to meet deadlines. Or, if you have questions about codes or specific files, you can reach out to your colleague in the next cubicle over to ask for a hand.

Full-time Work

Most medical billers and coders work full-time jobs. Unless you work in a 24-hour hospital, you can expect normal business hours for your schedule. Due to the ongoing nature of the work that requires a cohesive process, full-time work is usually needed in this field.

Is There a Demand for Medical Billers and Coders?

Yes. The Department of Labor Occupational Handbook reports an expected 13% growth in the medical and coding field. In 2017, the median salary was $39,180 a year.

A professional coder can work in a variety of positions including: surgical coder, coding specialist, reimbursement coordinator/specialist, and more.

A certified professional biller may find work in facilities including hospitals, ambulatory surgical centers, and physician offices.

Ready to learn more about becoming a certified medical biller and coder? Reach out to a MedCerts Education Consultant today!

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Published on January 18, 2019