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Medical coding and billing professionals work in one of America’s fastest growing professions. These workers fall under the US Bureau of Labor Statistics (BLS) category of medical secretaries; in total, between 2016 and 2026, employment in this field will increase by 22% and create 129,000 new jobs. The demand for more health services is expected to increase as the population ages.
Learn How To Do Medical Billing And Coding
Every medical practice needs someone to perform medical coding and medical billing for insurance and patient invoices. Doctors or facility managers may perform these tasks in addition to their other duties, or they may hire one or more employees to perform these tasks. Because clinical staff are focused on patient care, they often refer to professionals trained to handle the important administrative work of coding and billing to ensure that health care providers are reimbursed for their services.
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Does the idea of working as an accounting and coding professional appeal to you? Let’s take a look at what to do in this fast-growing industry.
The coding and billing specialist helps the healthcare facility manage insurance claims, invoices and payments. The daily work of a medical coding and billing specialist includes:
Although these workers often work in the same health institution where patients receive treatment, this is primarily office work as opposed to patient-oriented clinical work. A medical coding and billing specialist will spend a lot of time on a computer reviewing, entering and updating data.
Job descriptions often combine invoicing and coding. However, they are technically two different job functions, each with their own responsibilities and duties. Many medical departments will hire one person to do both jobs, and larger facilities may split the job into two separate jobs, so understanding the trade-off between these two roles is important.
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Medical coding is taking the provider’s diagnostic and procedure notes and converting them into valid codes for tracking and billing purposes. Codes are industry standard alphanumeric combinations used to identify services provided and billed. This will require knowledge of the various codes used:
Each of these codes is used in insurance billing, and the coder must follow specific instructions for proper use and placement of the billing software.
Codes can be entered as soon as patients are scheduled. There will be codes for visit type and patient-reported symptoms. Additional codes will be used for symptoms observed by medical personnel, tests and procedures performed, diagnoses and recommended treatments.
After coding is complete, medical billing specialists create invoices and send claims to patients’ insurance providers (or other payers). Based on these codes, insurance companies will approve or deny payment requests. Any remaining amount not paid by the insurance will be sent to the patient for reimbursement.
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The billing process often begins as soon as the patient meets with the medical department, as codes can be entered and sent to the insurer for pre-approval. This helps to determine what the patient’s out-of-pocket costs are, so that the office can invoice the patient accordingly at the time of the visit.
A medical informant must understand the industry codes, even if someone else codes them, because the billing specialist must review the reasons for insurance claim denials and may be responsible for updating the codes before claims are resubmitted. They will also check that the codes have been entered correctly before submitting the first application.
After the insurance payment has been settled, the remaining amount will be invoiced to the patient. This process also applies to the medical billing specialist. They also establish medical billing requirements, track payments, and track payments from insurance companies and patients.
If the bill is not paid, the billing professional should contact the insurance companies and make sure all the paperwork is in order. If the patient does not pay for the unpaid bill within a certain time frame and does not respond to further requests, the billing specialist may transfer the debt to a collection agency.
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Because billing and coding processes are so intertwined, many medical departments hire coding and billing specialists with training to fill both roles. Although some larger facilities may use separate teams for billing and coding tasks, these individuals usually work together to ensure that the process is done correctly. The most important thing is to avoid coding and invoicing errors so that payments are collected when collected.
Although job titles and descriptions for medical coding and billing specialists may vary, the basic requirements are often the same. Knowledge of the necessary codes is the most important requirement, but there are other areas of knowledge that can increase your employability.
A basic understanding of medical terminology is essential for correct coding. This includes anatomy and physiology terms, diagnostic and procedural terminologies, etc. includes Understanding the terms most commonly used in the medical profession will help with billing and coding.
You must be able to do basic arithmetic to determine the correct settlement amount. Although the billing system can automatically populate the correct insurance claim amounts based on the codes provided, you may need to calculate patient balances or set up payment plans where applicable.
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The medical billing and coding process requires a working knowledge of computer systems and relevant medical software. Ability to learn new programs is a plus.
Part of the medical bill may include contacting patients for payment. The ability to communicate effectively and professionally is essential to this aspect of the job. Some patients may feel stressed, angry or resentful when faced with medical issues and large bills, so good communication skills can make these conversations a little easier.
In addition to having a degree in computer literacy, the Medical Coding and Billing Specialist must be able to use a 10-key calculator, printer, copier, scanner, telephone system, and other similar basic equipment. If you’ve worked in an office, you’ve probably used these tools and you shouldn’t have a problem.
Although certification is not required by every employer to find a job as a medical coding and billing specialist, having an industry certification can make it easier to find a job. A medical coding certification can increase your earning potential.
Ways To Get Medical Billing And Coding Certification
The BLS reports that the average or median salary for medical accountants and coders in 2017 was $3,410,610 per year. From AAPC you can earn even more with years of experience. A 2017 AAPC salary survey found that coders with an average of 13 years of work experience and CPC certification earned a median annual salary of $54,106.
While work experience and other requirements are required for full CPC certification, those who pass the exam but do not have the required experience may be awarded the CPC Apprentice (CPC-A) designation. After submitting proof of two years of work experience or 80 contact hours with a coding preparation course and one year of work experience, a CPC student can achieve full CPC status.
As you accumulate formal education, certification, and experience, your earning potential can increase, especially as you move into senior or supervisory positions.
A medical department will often require experience or certification to hire a new billing and coding specialist, and some may require (or require) applicants to have both. Earning a diploma or degree in medical accounting and coding can help you gain the knowledge you need to prepare for the certification exam.
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A medical coding and billing specialist requires good organizational skills. If you are a detail-oriented professional with good time management and the ability to manage multiple projects, a medical billing and coding job may be right for you.
The candidates must also be comfortable in an office environment, as the job requires a lot of time in front of a computer screen and work with patient files. It is important to have a good understanding of medical terminology, or at least be prepared to learn it. Workers in this field must keep up to date with changing coding procedures and guidelines, so an interest in continuous learning is a good quality for this role.
If this description sounds like you, training as a medical coding and billing specialist may be a good career choice.
You can start with an online diploma or diploma in medical billing and coding from Ultimate Medical Academy. Not only will your UMA education provide you with a credential, but it will also prepare you to take the CPC certification exam.
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