What Do Medical Billers & Coders Do?
Medical billers and coders are highly skilled professionals who work with health care providers to process medical claims. Medically trained and specialized, they ensure that patients receive the benefits they deserve and that medical practices receive payment for their services.
While medical billing and coding are two separate fields, they go hand-in-hand in the healthcare industry: medical billing refers to submitting insurance claims for coverage; coding refers to assigning ICD-10 or Current Procedural Terminology (CPT) codes—which denote procedures, diagnoses, fees and treatments—to each claim.
Medical biller jobs require less education than those in other areas of healthcare administration like nursing or pharmacy management, but still require a strong background in math skills (especially computer operations). In addition to having excellent communication skills and attention to detail, successful applicants should have working knowledge of CPT/ICD-9 diagnostic codes as well as Medicaid/Medicare reimbursement structures.
Where Can a Medical Biller and Coder Work?
The medical billing and coding career is one that can be found in a number of different settings. The most common locations are hospitals, healthcare providers and medical billing and coding companies.
- Hospitals: Medical billing and coding professionals will work for a hospital directly or for an outside company that provides services to the hospital. They work with physicians who do the actual care for patients through the patient admission process, so it's important for them to have excellent communication skills so they can work well with everyone involved in each case.
- Healthcare Providers: In this setting, medical billers and coders will help doctors' offices manage their paperwork throughout treatment processes. It's important that these professionals have strong attention to detail since they are responsible for making sure all information on forms is correct before submitting them to insurance companies or other third parties (such as Medicare).
The Difference Between Medical Billing and Medical Coding
Although it's not always easy to tell the difference between medical billing and coding, these two roles are very different. They are both part of the healthcare industry, but they are different types of jobs that serve different purposes.
Medical billing is a role within the healthcare industry where you will be responsible for receiving payments from patients or insurance companies on behalf of doctors, clinics and hospitals. Your job responsibilities include:
- Collecting fees from patients or insurers
- Receiving payment by check, credit card or electronic funds transfer (EFT)
- Entering medical information into an electronic database
What Does it Take To Become a Medical Biller and Coder?
Medical billing and coding is a growing field, but it's not always easy to get started. While many medical billers and coders have some type of degree, you don't necessarily need one. Depending on your career path, you may be able to enter the field with a high school diploma or GED and maybe even work your way up from there.
The most common types of education include:
- A high school diploma or GED
- A certificate or associate's degree in medical billing and coding
- A certificate or associate's degree in another related field such as healthcare administration or computer science
- A bachelor’s degree in any subject area (this can include degrees like biology)
- A bachelor’s degree focused on healthcare management or information technology