What Does a Medical Biller and Coder Do?

Are you considering a career in the healthcare field, but not sure what to do?  Not all options involve being a nurse or doctor. If you have an eye for detail, you may want to consider becoming a biller or coder.

The job outlook for this field is good, with an 11 percent increase projected through 2028, which is higher than average.

So, what is medical billing and coding? Keep reading to find out.

What Is Medical Billing and Coding?

Medical billing and coding are related functions in the health care industry. They are not the same but go together for medical practices and hospitals to ensure they get paid for their services. For medical billing outsourcing process involves submitting claims to insurance companies or third-party payers like Medicaid and Medicare. This requires the use of standard classification systems to navigate through a doctor’s documentation and assign codes for the treatment provided. The medical coding process is where coders review the documentation from the patient visit, assign appropriate codes, and translate this into a format that can be sent electronically to a clearing

Let’s take a look at the difference between the two.

Medical Billing

Medical billing involves submitting and processing claims with health insurance companies for payment. Medical billing translates the service into a claim.

The medical biller must follow up on the claim to make sure the practice is reimbursed for its services. A knowledgeable biller optimizes the revenue for the medical practice.

Medical Coding

Medical coding is a translation. The coder takes something that is written one way like a diagnosis or prescription and turns into a code, either numeric or alphanumeric. Every diagnosis, injury, and medical procedure has a corresponding code.

There are thousands of codes for these procedures, so it’s important that the person codes accurately. Medical coders and billers translate every bit of information into these codes for billing.

These codes are vital to get an accurate bill of services rendered.

Read More: 5 Things to Remember When Opening Your Own Medical Clinic

Medical Biller and Coder Jobs

Let’s take a look at the medical biller and coder role, also known as health claims specialists. These employees work in a professional office building. They need to be organized and have an eye for detail to ensure claims are handled accurately.

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Here are some of the typical responsibilities for those in medical billing and coding:

  • Use a coding system for procedure and diagnosis codes
  • Enter these codes in the patients’ electronic health records
  • Review claims and work with other staff members to ensure accuracy
  • Use these codes for billing programs
  • Interact with patients and insurance companies for clarification
  • Follow up on late payments
  • Verify all payments and reimbursements are on time

As you can see, it’s important for this person to keep up with changes and advancements in the medical field.

Finding the Job

If you are interested in working in medical billing and coding, there are programs to help you prepare for this career. You will need to become familiar with medical terms and be familiar with the healthcare industry.

You will also want to look at certification programs to help you stand out against other candidates. 

Final Thoughts

If you are looking into a new career, you may want to consider medical billing coding. Hopefully, we answered the question “what is medical billing and coding,” so you know if this position is right for you.

Keep checking out our site for other articles like this to help launch your professional career.

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