Healthcare is a growing landscape. As it expands, the need to fill positions grows as well. While most people associate positions in healthcare with doctors or nurses, there are plenty of other needs to be filled, like medical billing and coding.
Medical coders and billers are essential to any medical practice. While doctors and nurses take care of patient needs, medical coders and billers handle the administrative duties that help keep the facility running smoothly.
Wondering if this is the profession for you? Let’s take a deeper look at what you can expect as a medical coder and how to become one.
What Is Medical Billing
Medical billing is exactly what you’d expect—the process that healthcare organizations use to submit claims to payers and bill patients. The medical billing process is typically started as the medical coders translate medical records. So what do medical billers do? Billing specialists generate invoices for patients and send claims to their insurance providers or whoever is paying.
Duties of a medical biller include:
- Create and submit reimbursement claims based on provided codes for diagnosis and treatment.
- Ensure the accuracy of codes and claims and represent the level of care provided.
- Work out any discrepancies or disagreements between providers, coders, and insurance companies.
- Assist patients in getting reimbursement for remaining costs uncovered by insurance companies or other payers.
- Contact medical providers and insurance companies to get pre-authorization for treatments or procedures.
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What Is Medical Coding
When a patient comes into a physician’s office or hospital, the healthcare provider will detail their visit in the patient’s medical record. Accurately maintaining patient records—for services, medications, or procedures they may receive—ensures proper billing and coding.
After the patient’s visit, the medical coder will review and analyze clinical documents. They’ll begin connecting services with billing codes related to a diagnosis, procedure, charge, and professional and/or facility code. The medical biller will use this code to send invoices to insurance providers or patients.
Duties of a medical coder include:
- Check medical documents and transcribe notes into diagnosis codes, treatment/services codes, and medical hardware codes.
- Communicate with medical providers and insurance companies or other payers.
- Work with and confirm details with medical providers to ensure accuracy.
- Use coding software, patient record platforms, and other digital tools.
What Does a Medical Biller and Coder Need To Know?
Both medical billing and coding require that you know medical terminology and industry-standard codes, like the International Classification of Diseases (ICD). Some key terminology to know may include physiology terms, diagnosis, procedural terminology, etc. Once you’ve gained a basic understanding of these terms, you can navigate the billing or coding process.
Other Skills Requirements
- Math skills—while you won’t be using calculus or the pathogen theorem, you will need to do basic math to determine bill amounts. Your billing system will automatically populate forms with the correct amounts; you’ll occasionally need to calculate the remainder for patients or help them set up a payment plan.
- Computer skills—as a coder or biller, you’ll be using a computer daily. You’ll need to be familiar with computer systems and medical software used today.
- Communication skills—medical billers are likely to be interacting with patients for payment. Some patients may be stressed out or worried about their diagnoses or ability to pay. You’ll need to communicate calmly with patients to ensure a positive outcome.
- Familiarity with office equipment—outside of your work computer, you’ll be using calculators, printers, scanners, and other basic office equipment. Knowing how to use each will make your job easier.
How Do I Get Started?
Does a career in medical billing or coding sound right for you? Then don’t waste another minute. Learn more about medical billing and coding programs at EIT. Our nine-month program provides you with the skills and knowledge you need to start a rewarding career in healthcare.
Ross Aresco is the CFO of Erie Institute of Technology. Erie Institute of Technology (EIT) is an Erie Pennsylvania technical/trade school providing training programs for medical, computer, electronics, manufacturing, and technology careers. EIT offers programs in many different areas to suit your interests and talents.