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Medical billing and coding: Your guide to getting started

Medical billers and coders ensure the accuracy of coding and claims processing, evaluating patient health outcomes, and maintaining compliance.
Written by Tanika Johnson, Contributor

Are you ready to make an impact in the healthcare field? Consider a medical billing and coding career.  Medical billers and coders use computer and literacy skills along with critical thinking to perform their jobs.  

Medical billing and coding is in demand and has been projected to grow. Explore your career options with a certificate or diploma program or associate degree.  

What is a medical biller and coder?

Medical billing and coding are two distinct jobs with some overlap. Skilled medical billers and coders may perform one or both roles. 

Essentially, medical coders are responsible for transcribing codes for claims processing. Medical billers file claims and keep record of insurance reimbursement.

Medical billers and coders may perform the following tasks:

  • Auditing and submitting insurance claims
  • Verifying insurance benefits and eligibility
  • Researching and appealing claim denials
  • Evaluating medical statements and patient records
  • Ensuring HIPAA compliance and patient confidentiality
  • Maintaining information security with patient health information
  • Translating diagnostic and medical information for coding
  • Communicating with healthcare providers to ensure accuracy with coding

Medical billers and coders nearly work in every healthcare setting such as hospitals, surgery centers, and healthcare offices. 

Industry professionals work with healthcare providers, patients, and insurance companies as well as other patient care staff and public health agencies.

Should I go into medical billing and coding?

Medical billers and coders spend prolonged periods on the computer evaluating patient data, tracking healthcare outcomes, and auditing the accuracy of claims processing. Industry professionals must demonstrate their communication, problem-solving, and analytical skills.

Think about your strengths.

Skilled medical billers and coders demonstrate strengths in organization, attention to detail, and ethics. Industry professionals use their active listening skills, communicate effectively, and work well under pressure. 

Medical billing and coding roles are well suited for independent workers accustomed to high levels of autonomy. Students possessing strong analytical skills may have a knack for analyzing health records and verifying the accuracy of patient health information.  

Consider your interests.

If you enjoy organizing healthcare data and tracking patient outcomes, then consider a medical billing and coding career. Medical billers and coders comply with HIPAA and patient confidentiality laws and demonstrate ethical behavior. 

Successful billers and coders work independently while paying close attention to details and maintaining an organized workspace.

Visualize the kind of career you want.

Medical billers and coders spend a considerable amount of time updating medical records and tracking patient outcomes. 

In hospitals and long-term care facilities, medical billers and coders may work second and third shifts. There are opportunities for remote or work-from-home positions. 

Medical billing and coding can be stressful. However, with the right balance of organization and time management, industry professionals can achieve productivity. 

Industry professionals must stay current with medical coding procedures, healthcare compliance, and government regulations. The US Bureau of Labor and Statistics reports that medical billers and coders earn a median annual wage of $51,840 as of May 2020. 

How do I become a medical biller and coder?

Prospective students may complete a certificate or diploma program as well as earn an associate degree to broaden career opportunities. 

For management roles, medical billers and coders may pursue their bachelor's degree. While some employers may accept a high school diploma and healthcare experience, others require a formal education program. 

Several employees expect job candidates to be certified. Students typically earn their certificate or diploma in 9-12 months and associate degree in two years. 

After completing a medical billing and coding program, students may register for the Certified Professional Coder, Certified Coding Associate, or Certified Billing and Coding Specialist exam.

What skills do I need to work in medical billing and coding?

Industry professionals must have knowledge of CPT, ICD-10, and HCPCS coding guidelines and patient confidentiality laws. 

Medical billers and coders apply concepts, procedures, and theories to billing and coding scenarios. Industry professionals interact with providers, billing departments, and patients while demonstrating proficient communication skills. 

People skillsTechnical skills

  • Effective communication 
  • Conflict resolution
  • Attention to detail
  • Time management
  • Self-motivation

  • Medical terminology 
  • Computer literacy
  • Familiarity of HIPAA compliance
  • ICD-10 and CPT coding knowledge
  • Accounting and bookkeeping procedures

In conclusion

Medical billers and coders are integral to the healthcare sector. Industry professionals serve as liaisons between the providers and billing departments and develop procedures for electronic record retrieval and reimbursement. 

If you're passionate about the healthcare field, then take the next step. Enroll in a medical billing and coding program.

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