Becoming a Medical Biller or Coder

A career that has been rapidly growing in recent years is medical billing and coding. There is currently an increased need for this profession since medical billers and coders handle payments for healthcare providers, patients, and insurance companies.

It is a rewarding career in the healthcare system that does not require a person to spend the time and money needed to earn a nursing or medical degree but will still launch a medical career for those looking to be in the medical field.

Medical Coder

Many times one person will be in charge of coding and billing, but it can be done by separate people as well.

A medical coder could be considered a translator between medical professionals and insurance companies. They take medical terms such as various treatments, services, equipment, and procedures and turn them into specific codes. Through these codes, healthcare providers can obtain correct payments either through insurance companies or the patient themselves.

There are a variety of settings in healthcare a medical coder can work in, so their tasks may vary depending on that. However, each coder has common responsibilities, such as examining a patient’s records and clinic reports, looking into payment information and reimbursement, translating the medical notes into codes, and performing audits to ensure accuracy.

Medical Biller

Once the medical terms have been translated into codes, the next step is for the medical biller to take those codes and submit claims to insurance companies and patients.

Medical billers do not provide any patient care, but they are the ones who may work with the patients on some level. For example, they may need to contact the insurance company, healthcare providers, or the patient to discuss the various charges.

Other responsibilities a medical biller is in charge of include things such as verifying insurance coverage, referrals, and pre-authorizations. They may also set up payment plans and collect accounts that are past due or appeal insurance claims that were denied. A medical biller also must have a working knowledge of HMO/PPO, Medicaid, and Medicare coverage.

Steps to Become a Biller or Coder

The steps one needs to take to become a medical biller or coder are not as extreme as those looking to become medical providers or nurses. However, there are still specific programs and certificates that must be earned to enter this field.

The first step is to earn a high school diploma or GED. Certain entry-level jobs in billing and coding can be pursued with a diploma or GED certificate. The next step is to register for a medical billing and coding program, which can take a year or less for a person to complete. Although, many employers prefer to hire those who have earned an associate degree, which takes about two years to earn.

Once a degree is earned, the person must pass the certification examinations. Many healthcare providers prefer their medical billers and coders to have acquired a professional certificate. Because of this, those who have the certificate will have more job opportunities.

After all that, the last step is to find employment which will be made easier when all these efforts have been followed.

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