The main task of a medical biller/coder is to make sure that the health provider gets paid for the services that they provided to the patient. When a patient uses insurance to cover medical expenses, the medical biller/coder is responsible for making sure that the the physician and the insurance agency get paid. This is important for all parties involved, including the physician, patient, as well as any third-party payer.

Each medical service is assigned a code, and the medical biller is in charge of entering the different codes into the database. The database creates a proposal that is sent to the right insurance carrier and can either be accepted or denied. If the proposal is accepted, then the physician gets paid and a bill is sent to the patient if there is any additional cost.

If it is rejected, then the biller must look at the proposal again to determine any errors and then update the database with any new information that is found. Once the problems have been sorted out, then the healthcare provider gets compensated accordingly. In addition to all of this, the biller deals with collecting unpaid bills from patients as well as finding fraudulent claims that have been filed.

The proper training and education is needed to excel in this field. The codes and medical terminology are needed to be understood in order to fulfill the tasks of a medical biller/coder. It is important to be self-motivated and competitive because this career is highly desirable. A coder should also be extremely organized due to the high volume of documents he or she will be dealing with, as well as paying a lot of attention to detail.

Job Description

The career of a medical biller and coder involves understanding the different terms that are used in the medical field. On a day-to-day basis, they translate a patient’s medical file into a code that is entered into a machine to compile a statement. This statement is sent to the patient’s insurance company, and if the insurance company approves of the statement, then a bill is created and the job is complete. If the insurance company denies the statement, then it is sent back to the biller/coder and it must be examined to determine the mistake.

Average Salary Range

With job opportunities on the rise in the healthcare industry, the salary is also increasing. A medical biller and coder will make an average salary that range from around $36,000 up to over $44,000 a year. There are many factors that affect the medical billing and coding salary for a person. These include things such as what specialty the coder is working in, experience in the industry, as well as the geographic location where he is working.

Type of Industry

Due to the many sub-fields of general healthcare (surgery, dentistry, general practice, etc.), coders are paid higher depending on which field they are working in. For example, in a specialized field such as neuropsychology, the employees who work in the industry are paid very well. This means that the coder working in this field would also receive high compensation. Coding in this industry requires a little bit more expertise than just general coding.

Experience

With more experience with coding, potential employers see the coder as being a better asset to the staff and will pay more as a result. Employers realize that the more experience a coder has, the less time will be needed to train him and he is seen as being an efficient and profitable team member. Employers also realize that a coder with a lot of experience has attained skills that will be useful with the job, and they understand that other healthcare facilities will also be interested in this person and will offer more pay in order to keep him from venturing away to another company.

Geographic Location

Geographic location is also an important concept to understand when looking into a medical biller and coder’s salary. When the coder is living in a large city such as Manhattan where the cost of living is high, he is going to get paid more than a smaller city. This is due to the fact that the bigger cities are more economically stimulated, meaning that there is more money that is spent on things like rent and groceries, and the salaries are higher to compensate for such factors.

With the healthcare industry at its highest, demand for medical coders has severely increased. Coders need to possess skills such as attentiveness to detail, thoroughness, organization skills, and keeping matters private when considering this profession. One needs to have the proper training, education, and certification before excelling in this lucrative career path.

Training Program

The most convenient way to get certified for medical coding is to enroll in an online training program. The online course will be just as difficult as taking the course in a classroom setting, except the student will have more flexibility and independence when learning the material. A high school GED or diploma is generally needed before pursuing any type of certification training. For medical coding, a general knowledge test of computer usage ability usually needs to be taken before the training begins.

Online Courses

For online training, courses such as anatomy and physiology, medical terminology, pharmacology, reimbursement processes, health care information technology, disease classification, and an internship or externship are usually the ones that are necessary to take. Having an interest in the medical field, or having any background knowledge will be helpful when taking these courses. In addition, most online universities have a tutorial that can be helpful to those students who are unfamiliar with taking online courses.

Certified Coding Associate (CCA) Exam

When the training is complete, an exam is needed to be passed before receiving the certificate. The exam will cover everything that is learned during the training session. The basic exam that will be taken is the Certified Coding Associate (CCA) exam. It is a multiple choice exam of 100 questions about topics like health records, reimbursement methodologies, medical terminologies, in addition to various other topics that will be learned during the training session.

Career Options

With a medical coding certification, there are options to work in almost any type of healthcare facility, such as hospitals, doctor’s offices, outpatient clinics, or nursing homes. With enough experience, working at home is also an option. There are also several different types of careers that can be obtained with a certificate, like a coding and compliance manager, medical coding specialist, coder/revenue analyst, and many more. For some of these careers, employers will want a candidate with a bachelor’s degree, but will also accept a person who has experience within the field.