What Does A Medical Billing And Coding Job Involve?
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by
Angela Foster·
Medical billing and coding are valuable services of the healthcare industry. Medical billers and coders ensure revenue cycle management (RCM) is successful. The financial viability of a healthcare practice relies a lot on the RCM.
A healthy revenue cycle should follow billing and collection best practices to ensure bills are submitted in accordance with payor requirements and all services provided are billed. The last thing that a healthcare organization needs is to provide services and not be paid. (1)
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Medical Billing And Coding Job Is In Demand
There’s a lot of reason why you should consider a medical billing and coding job. For starters, it’s a very fulfilling job. You don’t need to attend medical school to be a medical and coding specialist.
Aside from being fulfilling, the medical and coding job is in demand. The medical billing and coding career outlook looks bright compared to many other career fields, with growing employment opportunities in a variety of settings including hospitals, insurance and pharmaceutical companies, and skilled nursing facilities. (3)
First, it is the administrative function related to medical billing and coding services that ensure insurance companies pay for the services provided to the patients. The medical billing and coding process begins with patient enrollment and ends when you receive full payment after services are delivered to the patients.
The medical billing and coding process may take anywhere from several days to many months, depending on how complex medical services are, the frequency of claims, and how healthcare providers collect their patients’ medical liability.
If the billing and coding process takes too long, the insurance company might reject the patient’s application, or the physician might not be paid for the services provided.
Ensures Best And Standard Practices Are In Place For Payment And Collection
Second, medical billing and coding encompass collections activities related to the actual service provided to the patient. As an example, billing for laboratory tests, medical diagnostic tests, patient treatment, and surgery is included in the medical billing and coding process.
These healthcare services must pass all relevant government requirements before they are covered by insurance companies. Once these are authorized, the biller will then generate a medical record of the procedures and outcomes related to the tests and/or services.
Understanding how health information is coded in health records is critical. This involves knowledge of both medical billing and coding systems and familiarity with medical billing and coding systems and software.
Individuals who successfully complete the exam and meet certain educational requirements are then certified by the American Health Information Management Association (AHIMA). Becoming certified in AHIMA enables medical billing and coding professionals to perform their job with greater confidence. Certified personnel are able to interact more effectively with healthcare providers, patients, and employers.
Continuous Training And Learning
Fifth, becoming a medical billing and coding specialist requires continuous training in the application of the codes used in the system. Training involves both technical skills and knowledge of the codes.
It is not enough for medical billing and coding specialist to know how to use the codes they are responsible for using; they must also understand how these codes apply to different medical offices or settings, as well as how billing and coding offices choose which codes to use in their process.
In addition, medical billing and coding specialists need to understand how to interpret these codes. Medical offices and providers choose which codes best describe their services and/or data. To ensure that the medical biller and coder is always up for the job, continuous training and learning is required.
Differentiate The Various Settings Of A Medical Billing And Coding Job
There’s a lot of settings for the medical billing and coding job. It is critical that the medical billing and coding specialist know the differences between medical facility codes and patient ledgers.
Facility codes are primarily concerned with insurance claims and collections. A medical biller may work in a hospital, doctor’s office, clinic, or hospice, where medical coders are often assigned to specific medical offices or facilities. On the other hand, a medical biller may work in private practice, working with one patient and his or her health insurance provider.
Other Qualities Of A Medical Billing And Coding Specialist
A good medical billing and coding specialist should have analytical skills. Medical coders need to be able to analyze the information in the patients’ records in order to determine what codes are appropriate. This is important so that the billing is accurate and the healthcare service provider gets paid on time for the services rendered. (4)
Detail-oriented is another quality of a good medical billing and coding specialist. Accuracy and attention to detail are of highest importance for medical coders. Processing health insurance claims and understanding the medical coding system are two skills that require a keen eye for detail. (5)
Other qualities are integrity, good interpersonal skills, and technical skills. If you’re confident that you possess all these qualities, take advantage of the many medical billing and coding online courses to get started.
