What’s Medical Billing & Coding? Job Description & Career Paths
Medical coders and billers are an essential liaison between patients, doctors, and insurers.
Medical billers and coders read patient charts to determine history with the diagnosis and treatment.
Based on these data, they use a set of established medical codes to transcribe patient history in a shorthand that healthcare providers and insurers will use.
A similar career to these two, which is often available through the same programs, is medical transcriptionist.
Medical transcriptionists have the same jobs as medical coders and billers, but they listen to the diagnosis and treatment plan of a physician and code them based on this.
Medical billers and coders, on the other hand, use the information from the doctors’ reports.
The current code set used for diagnoses and treatments is ICD-11.
ICD means the International Classification of Diseases.
With this code set, coders can be more specific in their documentation than with previous versions of ICD.
What Does a Medical Biller and Coder Do?
Generally, medical billers and coders have the same duties despite the employer.
While working in clinics, physician offices, or hospitals, they use medical codes to record the diagnoses and treatments of a patient.
Their duties include:
- Reading and analyzing patient records.
- Using codes to bill insurance providers.
- Determining the correct codes for patient records.
- Managing detailed, specifically-coded information.
- Keeping track of patient data over multiple visits.
- Maintaining patient confidentiality and information security.
- Interacting with physicians and assistants to ensure accuracy.
Even though medical billers and coders work in hospitals or clinics, they are far from patient care sites.
They have to interact with physicians and assistants, but most of their work in independent of anything that happens in a healthcare facility.
What Career Paths Can I Take as a Medical Biller and Coder?
Medical coders and billers must maintain excellent focus and concentration, no matter in which environment they are.
Every day they deal with all types of patient charts, which need to be coded correctly and then submitted for billing to insurance companies.
Medical billers and coders may work at:
- Home health care services.
- Nursing care facilities.
- Physicians’ offices.
You can choose a similar career as a medical transcriptionist in the same workplaces where medical billers and coders work.
These professions are popular among those who look for self-employment.
In this case, you may work remotely or consult on-site.
Medical coders usually work remotely while partnering with a health care facility which sends the information that needs to be coded to bill insurance companies.
Medical Coding Training Scams
You have probably seen ads about medical billing and coding “work-from-home” jobs.
They promise a lot of business and lucrative careers even for those who don’t have any experience in the field.
This is one of those “it sounds too good to be true” instances.
The Federal Trade Commission filed multiple charges against companies for making false claims about the amount of business and potential earnings.
Medical facilities and doctors rely on medical billers and coders to be reimbursed, so they are looking for people with an education from a reputable program.
You have to be knowledgeable about:
- Filling out complex insurance claim forms.
- Insurance guidelines, the claims submission process, and procedures.
- Following up with the appropriate parties (insurance companies and patients) to ensure bills are paid.
- Generating accounts receivable report clients.
- Analyzing Explanation of Benefits (EOB) forms to ensure insurance companies have paid for charges.
If you want to work from home, you have to research the need for medical billers and coders in your local market.
You should create a business plan and have an area at home dedicated to work.
You will have to follow the same health privacy laws (HIPAA) as medical offices do.
It’s essential to have a location where no one else can access medical records.
Most medical health technicians work as coders.
Another growing sector for these technicians is cancer registrars.
They are responsible for:
- Analyzing and compiling patient information for research purposes.
- Reviewing patient records and pathology reports for accuracy.
- Conducting annual follow-ups to track treatment.
- Assigning codes to represent the diagnosis and treatment of cancers.
While the employment for all medical coders and billers is steady, the demand for cancer registrars is expected to keep growing.
With the aging population, more types of special purpose registries are likely to appear because of many types of diseases detected and treated later in life.
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