Medical billing and coding is a process that starts with a patient’s visit to a healthcare provider. The provider will document the services that were rendered and the diagnosis for the patient. This documentation is then sent to the medical billing and coding specialist, who will create a claim. The claim is then submitted to the insurance company for reimbursement.
Medical billing and coding specialists play an important role in the healthcare system. They ensure that providers are reimbursed for the services they render and that patients are only responsible for their portion of the bill.
If you’re interested in a career in medical billing and coding, this blog post is for you. We’ll discuss what a medical biller and coder is, the education and training required, job duties, work settings, salary, and advancement opportunities.
What is a medical biller and coder?
A medical biller and coder is a professional who is responsible for translating medical reports into codes used by insurance companies. They also work with patients to determine what their insurance will cover and how much they will need to pay out of pocket. In order to become a medical biller and coder, one must have a high school diploma or equivalent, although some employers may prefer candidates with postsecondary education. There are also certification programs available that can help improve one’s chances of getting hired or advancing in their career.
Education and training
Education and training are critical for anyone seeking a career in medical billing and coding. There are many schools that offer certification programs specifically in medical billing and coding, which can be completed in as little as six months. However, many employers prefer to hire applicants who have completed a two-year associate’s degree program in health information technology.
While certification and degree programs will vary slightly from school to school, most will include coursework in medical terminology, anatomy and physiology, health data requirements and standards, classification and coding systems, reimbursement methodologies, and healthcare law and ethics. Once you have completed your education or training program, you will likely need to obtain certification from a professional organization such as the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC).
Job Duties
The job duties of a medical biller and coder can vary depending on the size and type of facility they work in. However, there are some common tasks that most billers and coders will perform on a daily basis.
One of the most important duties of a medical biller and coder is to review patient records and documentation to ensure that all the required information is present. This includes making sure that diagnoses are supported by laboratory tests, physician notes, and other documentation. Once all the necessary information has been gathered, the medical biller and coder will assign the appropriate codes for diagnosis and procedures using classification systems such as the International Classification of Diseases (ICD) or the Current Procedural Terminology (CPT).
After the codes have been assigned, the medical biller will generate invoices and submit them to insurance companies for reimbursement. In order to do this, they must be familiar with different reimbursement methodologies such as fee-for-service or capitation. They may also be responsible for following up with insurance companies if claims are denied or payments are delayed.
In addition to billing and coding, many medical billers and coders also perform administrative tasks such as scheduling appointments, maintaining patient records, and verifying insurance benefits.
Work settings
Most medical billers and coders work in doctors’ offices, hospitals, or other healthcare facilities. However, some may work for insurance companies, billing services, or the government. Billers and coders who work in larger facilities may specialize in a particular area, such as inpatient coding or outpatient coding. Those who work for insurance companies may review claims to ensure that they meet all the necessary requirements for reimbursement. And those who work for the government may process Medicare and Medicaid claims.
No matter where they work, medical billers and coders must be accurate and detail-oriented. They must have strong computer skills and knowledge of medical coding systems. In addition, they must be able to keep up with changes in the healthcare industry, as new procedures and codes are constantly being introduced.
Salary
The salary of a medical biller and coder can vary depending on their level of experience, education, and the type of facility they work in. Generally, medical billers and coders who have completed a two-year associate’s degree program and have certification from a professional organization such as the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) can expect to earn a higher salary than those who have only completed a certification program.
In addition, medical billers and coders who work in larger facilities such as hospitals or insurance companies may also earn a higher salary than those who work in smaller doctor’s offices or clinics. And those who specialize in a particular area of billing or coding, such as inpatient coding or outpatient coding, may also earn a higher salary than those who do not specialize.
Overall, the median annual salary for medical billers and coders was $32,350 in May 2016, according to the U.S. Bureau of Labor Statistics (BLS). The top 10% earned more than $52,040, while the bottom 10% earned less than $22,560.
Advancement opportunities
Medical billing and coding is a rapidly growing field, and there are many opportunities for advancement. Those who have completed a two-year associate’s degree program or higher will have the best job prospects and may be eligible for management positions. Additionally, those with experience in a particular area of medical billing and coding, such as inpatient coding or outpatient coding, may also be able to advance to positions with greater responsibility.
Most medical billers and coders start out working in doctors’ offices, hospitals, or other healthcare facilities. However, there are many opportunities to move into other settings, such as insurance companies, billing services, or the government. Billers and coders who work in larger facilities may have the opportunity to specialize in a particular area, such as inpatient coding or outpatient coding. Those who work for insurance companies may review claims to ensure that they meet all the necessary requirements for reimbursement. And those who work for the government may process Medicare and Medicaid claims.
No matter where they work, medical billers and coders must be accurate and detail-oriented. They must have strong computer skills and knowledge of medical coding systems. In addition, they must be able to keep up with changes in the healthcare industry, as new procedures and codes are constantly being introduced.
The salary of a medical biller and coder can vary depending on their level of experience, education, and the type of facility they work in. In general, those with more experience and education can expect to earn a higher salary than those who have only completed a certification program. Additionally, those who work in larger facilities or specialize in a particular area of billing or coding may also earn a higher salary. According to the US Bureau of Labor Statistics, the median annual salary for medical billers and coders was $32,350 in 2016, with the top 10% earning more than $52
References:
https://www.aapc.com/training/how-to-become-a-medical-biller.aspx
