4 Steps To Become a Medical Biller or Coder

Medical billing and coding careers are a great choice for individuals who aspire to work in the healthcare industry without spending a large amount of money on advanced degrees.

Careers in medical billing and coding are in high demand and can provide an endless amount of benefits. With many changes in the healthcare system, the job outlook for the profession is expected to grow by around 8% over the next 10 years.

Learn.org explains the role that medical billers and coders play in the healthcare system and informs readers of the necessary steps to become an expert in medical billing and coding.

What are Medical Billers and Medical Coders?

Medical billers are responsible for properly billing insurance companies and other payers for the care that a patient receives while a medical coder is in charge of accurately assigning the correct code for the care that is provided to a patient.

Medical billing and coding professionals can work in all kinds of healthcare facilities, such as:

• medical offices
• hospitals
• rehabilitation centers
• health departments
• long-term care facilities
• nursing homes
• prison systems

Although medical billers and medical coders are closely related to one another, they are two distinctively different careers that play a vital role in the healthcare administration field.

What is a Medical Biller?

Medical billers play an essential role in the healthcare revenue system. They are primarily responsible for the submission of claims to insurance companies and other payers.

If a bill payment is delayed, they are also responsible for following up with the patient and remaining in contact with the insurance company until the bill is paid.

By doing this, they are ensuring that a healthcare facility is achieving optimal revenues in the healthcare system.

Job Duties of a Medical Biller

In addition to the submission of claims, medical billers can be seen:

• ensuring that a patient has health insurance coverage
• reading and reviewing medical records
• recording payments as they are received
• gathering patient and insurance information before seeing a doctor or nurse
• obtaining recommendations and pre-authorizations for treatments as needed
• examining eligibility and verifying benefits for treatments, hospitalizations, etc.
• examining patient bills for accuracy and completeness

What is a Medical Coder?

Medical coders are ultimately responsible for assigning the correct codes to treatments that are carried out by clinical professionals during a patient's care.

Each code corresponds to different medical procedures, equipment, and ailments. It is the job of the medical coder to select the correct code that is further used to determine the cost of the service.

Job Duties of a Medical Coder

Although medical coders usually work independently, they must collaborate well with medical billers, physicians, nurses, and administrative staff.

Their typical day-to-day tasks may consist of:

• analyzing patient records and clinical reports
• researching reimbursement and payment information
• translating medical information into codes for billing
• ensuring codes are accurate and sequenced correctly
• following up with healthcare providers on insufficient documentation
• receiving and reviewing patient charts and documents for accuracy

Job Options in Medical Billing and Coding

Careers in the medical billing and coding field could have several different job titles. _

_Some of the job titles include:

• medical coding specialist
• medical records coordinator
• health information specialist
• medical records clerk
• medical records analyst
• health information technician
• health information clerk

Can One Person Fulfill Both Roles?

Most companies have different employees fulfilling the billing and coding duties. In some situations, one person can be both a medical biller and a coder.

This is typically seen in smaller companies and communities where the hiring pool is much smaller. Larger organizations, such as hospitals and health systems, typically keep the job roles separate.

Four Steps to Become a Medical Biller and Coder

1. Earn a High School Diploma (or equivalent)

An individual can pursue an entry-level job in medical billing and coding with only a high school diploma or GED. However, earning a certification becomes extremely useful in demonstrating a candidate's competencies and knowledge.

The majority of certification and associate degree programs require a high school diploma or GED for admission.

2. Enroll in Medical Billing and/or Coding Programs

Diploma and associate degree programs are the two most common educational pathways for medical billing and coding careers. The length of these programs can take anywhere between one to three years to complete.

The diploma programs provide training for national coding certification exams and entry-level positions.

Employers typically prefer to hire associate degree-holders. Throughout the degree programs, students take courses in medical terminology, coding, and information technology.

3. Earn a Certification

Earning a certification in medical billing and coding certainly helps a candidate become more attractive to a hiring manager.

The three major professional certifications are:

• Certified Coding Specialist (CCS)
• Certified Coding Associate (CCA)
• Certified Professional Coder (CPC)

By pursuing one of these certifications, candidates can demonstrate their understanding of complex billing and coding requirements.

4. Seek Out Employment

The last step consists of seeking out any opportunities to gain work experience in medical billing and coding. Seeking out internships is a great way to gain relevant work experience in an entry-level position.

Discover Your New Career in Medical Billing and Coding

Medical billing and coding is a growing industry that is continuously in need of experts in the field. With the rise in healthcare services, medical billing and coding careers are capable of providing rewarding experiences in the healthcare field.