What’s the Difference Between a Medical Biller and a Medical Coder?

difference of medical billers and coders
Understanding basic medical terminology and procedures will help you have a successful medical billing and coding career.

Medical billing and medical coding are often linked together so closely you might assume they are essentially the same profession. They both require many of the same skill sets and are often required to complete very similar, tasks. Both careers are a part of the administrative side of the healthcare industry. In reality, medical billing and medical coding are two different professions. Let’s take a look at some of the differences between the two career paths, as well as some of their similarities.

What Do Medical Billers and Medical Coders Do?

The jobs of both of these professions involve patient medical records. Medical coders assign the Current Procedural Terminology (CPT) codes to procedures and International Classification of Diseases (ICD) codes for the physician’s diagnosis of the patient. Simply put, medical coders review patient records, assigning the proper codes, based on the information provided, so that the insurance company can be appropriately billed.

Encoding patient records and properly filing insurance claims are some of the responsibilities of medical billing and coding.

Medical billers step in then, utilizing special billing software to enter all the assigned codes and other information so that the insurance claim can be accurately filed. Medical billers have more opportunity to interact with patients and medical staff directly, as they must not only obtain insurance information from the patient directly but also must be able to explain the nuances of insurance coverage, such as co-payments and deductibles. They follow-up with patients and insurance companies to see if claims have been paid. They also play a significant role as far as physicians go, making sure that they are receiving the reimbursement from insurance companies.

Training and Skill Requirements

Medical billing and coding training are often combined into a single program, with many career schools offering comprehensive programs using the most up-to-date coding and insurance information. Southern California Health Institute (SOCHi) offers a combined billing and coding program that covers all the major areas of medical billing and coding procedures that may be used either in an inpatient setting (a hospital or nursing home), as well as outpatient clinics and other medical facilities.

A high-quality program like SOCHi’s will offer a broad base of knowledge, including anatomy and physiology, and medical terminology, as well as classes in the operations of a medical office and the crucial ICD-10 coding.

Medical billing and coding careers require you to have two critical skills: the ability to think critically and acute attention to detail. Handling thousands of codes at a time can be stressful and frustrating, so you have to be able to focus on the detail of the patient records, selecting the correct codes to accurately bill. You also have to have the critical thinking skills to handle problems that will arise and to communicate effectively with patients, medical professionals, and insurance companies to resolve issues.

There are some distinct differences between medical billing training and the training that medical coders complete. Medical billing requires a good deal more contact with patients, as well as the doctors and medical professionals involved in treatment. Medical billers work with the insurance companies to ensure that claims are processed accurately and promptly. Medical coding is highly technically and requires a great deal of medical knowledge, including terminology and anatomy, to accurately assign codes. The differences between the two careers also make them highly complementary to each other, and you may find as you pursue a career as a medical billing and coding specialist that combining the two jobs is the best choice for you.

For more information about SOCHi’s Medical Billing and Coding Specialist program, please visit our website, or if your ready to start your new career path, apply here.


Learn More at Southern California Health Institute Newsroom

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