While you will be ready to start your career after you have passed your medical billing and coding certification exam, you should know that medical billing and medical coding are technically considered to be two separate jobs.
In many workplaces, a single person will be responsible for both aspects of the medical billing and coding job. However, if you work for a larger employee like a hospital or a specialized billing company, there is a good chance that you may end up specializing in just one of these areas. Therefore, it is important to understand the different responsibilities associated with both kinds of jobs in medical billing and coding.
Translating Medical Documents into Code
One of the core responsibilities of top medical coding jobs involves reviewing a patient’s medical record and converting all relevant information such as diagnoses, treatments and medical procedures into a standardized numerical code.
A medical coding job requires the professional to examine and understand a variety of medical documents such as doctor’s notes, laboratory results, prescriptions, surgical records and x-ray results. This means that medical coders must have a strong command of medical terminology in addition to medical coding systems like CPT, HCPCS or ICD. Accredited medical coding online programs or brick-and-mortar colleges will prepare you for both of these tasks.
Investigating and Clarifying Medical Records
Jobs in medical coding are not always as straightforward as converting a medical term into its appropriate numerical code. If a medical coder suspects that there has been a mistake in a patient’s medical record or if any aspect of it is unclear, the specialist must investigate to find out the source of the problem.
Sometimes a handwritten document like a physician’s order is unclear or illegible. Other times a procedure is incorrectly documented or does not seem to correspond with the patient’s diagnosis. In both cases, the medical coder must be able to recognize the error, detect its source and then search through additional documents or contact a healthcare worker in order clarify the mistake.
If you are a specialist responsible for only the coding aspects of the job, then it is important to remember that a career in medical coding may require little or no interaction with insurance companies, patients or medical workers. However, even if the tasks of the coder and biller are divided, a medical coder will frequently have to collaborate with a medical billing professional in order to create an accurate medical claim.
Medical billing jobs are sometimes considered a sub-specialty of medical coding. However, medical billers often act as the central link between healthcare providers, insurance companies and patients and therefore have a wide range of responsibilities. Two of the main responsibilities of a medical billing job are to make sure that all parties are billed correctly and that healthcare providers receive payment for their services.
These two broad responsibilities of jobs in medical billing involve a variety of sub-tasks. Some of these include:
- Communicating with medical professionals to clarify procedures, diagnoses and treatments if they are missed by the medical coder. Like the medical coder, billers must also be familiar with medical terminology as well as medical classification codes.
- Preparing medical claims which includes formatting invoices, filling out insurance forms and collecting necessary signatures.
- Contacting insurance companies when a medical claim has been denied, clarifying the specific reason for the rejection and then attempting to correct and resubmit the claim.
- Contacting patients in order to evaluate their financial status, set up payment options and follow up on overdue payments.
- Interpreting the Explanation of Benefits (EOB) from various insurance companies for patients and resolving patient complaints.
Performing on the Job: Important Traits
You will gain much of the professional knowledge needed for the best jobs in medical billing and coding when you prepare for your certification, such as learning the medical coding system and basic medical terminology. In addition to these specific skills, however, there are a number of personal characteristics that will support these skills and help you to be successful in medical billing and coding jobs.
Traits of Medical Coders
- Strong Attention to Detail: For insurance companies to be correctly billed and for healthcare providers to be paid, the medical coder must be able to detect the smallest mistakes or irregularities in a patient’s medical records in order for an accurate medical claim to be generated.
- Enjoys Working Alone: Unlike medical billers, the work of a medical coder is often solitary. While they may sometimes have to contact healthcare providers to clarify medical records, most of the medical coder’s work is carried out alone with a computer and stacks of documents.
- Good Computer Skills: Because most medical coding is done electronically, coders must be able to quickly and accurately enter information into computers using medical coding programs.
- Comfortable Working with Numbers: Most of the duties that medical coders perform don’t require math skills, but they do require coders to read and keep track of large amounts of information presented in numbers.
Traits of Medical Billers
- Strong Attention to Detail: If the medical coder misses a detail or makes a mistake, the medical biller must be able to catch it when they generate an invoice.
- Multi-tasking and Organization: Medical billers have a wide range of responsibilities and must be able to keep track of many medical claims at the same time.
- Communication Skills: Unlike the medical coder, the medical biller is usually the intermediary between healthcare providers, patients and insurance companies. A medical biller must be able to clearly communicate information to different types of people as well as resolve conflicts over things like insurance benefits, charges and late payments.