The typical medical billing and coding job description mentions assigning and translating codes for different services and diagnoses, but the responsibilities of professionals in this field often include a variety of other duties as well. In this article, we’ll take a comprehensive look at the day-to-day jobs of medical coders and billers, how the two different positions interact with each other, and why they are in such high demand in the health care industry. We’ll also discuss the increasing importance of medical billing and coding certification to those who wish to enter this field.
Standard Medical Billing and Coding Job Description
Contrary to popular perception, the jobs of the medical biller and Certified Coding Specialist are quite different (apart from the obvious similarity that both deal with medical codes). With that said, both do work interdependently in the field of medical administration, and both can acquire their training and certifications through the same medical billing and coding courses. Descriptions of each position follow.
Medical Coder Job Description
Medical coding professionals are responsible for a range of tasks associated with generating and managing records for all billable activities that take place in a health care facility. Those who work in this profession usually carry titles such as Certified Coding Specialist, Health Information Coder, Health Information Technician or Medical Coding Specialist. Regardless of which of these titles the individual holds, however, their daily duties often include the following tasks:
- Reviewing physicians’ notes and charts for accuracy
- Obtaining any necessary clarification of information on the notes and charts
- Ensuring that all medical records have been signed by the appropriate parties
- Assigning appropriate medical codes to all diagnoses or services
- Entering and organizing the codes into management software
In order to perform the job of a medical coder, the individual must be familiar with the ICD-9-CM, ICPM, DSM-IV and CPT-/HCPCS universal coding systems. These different numeric systems are designed to provide a description of the patient’s condition and specific services rendered by the health care provider in such a way as to eliminate any chance of misinterpretation by other parties.
Medical Biller Job Description
While the medical coder assigns codes to billable activities performed at the health care facility, the responsibility of the medical biller is to translate those codes into the nomenclature required by insurance companies so that the proper billing documents can be sent out. The Medical Billing Specialist, as most professionals who work in the position are called, generally performs the following duties:
- Translate codes into insurance companies’ preferred coding system
- Prepare the appropriate claims documents required by each insurer
- Submit, organize and track all insurance claims filed by the health care provider
- Follow-up until payment is received, and manage collections activities when necessary
In addition to their administrative duties, medical billers are also required to perform a variety of customer service functions. These often include answering patient questions on billing, arranging payment plans for those who need them, and handling collections if a patient fails to meet his or her financial obligations.
Why the Medical Billing and Coding Job Description is Changing
As technology continues to change the workplace, the traditional job description for medical billing and coding professionals is also evolving. The ability to handle the responsibilities of these positions remotely has led many individuals to create medical billing and coding jobs from home. The increasing use of data management software has led to an explosion of medical billing and coding schools online which can help students acquire the skills required to completely redesign their jobs. Couple these facts with the heightened reliance of employers who can handle advanced data management tasks, and it’s no wonder that the medical billing and coding job description is changing almost daily.