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.

Tags: medical billing, medical coding

This entry was posted on Tuesday, November 22nd, 2011 at 1:32 am and is filed under Medical Billing. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.