What Is a Medical Coding and Billing Specialist

A Medical Coding and Billing specialist is responsible for managing and overseeing insurance claims, invoices, and payments. In addition, they are responsible for the day-to-day patient records and documentation. 

Are you looking for a career in the healthcare industry? Do you have organization, communication, and time management skills? If so, a career in medical billing and coding might be a good fit for you!

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What goes on in Medical Coding?

A medical coder converts diagnostic and procedural notes into the correct codes for record-keeping and is used to identify the services that will be provided and billed by the provider.

Types of coding that may be used on the job:

  • Current Procedural Terminology (CPT) - These types of codes are used to identify procedures and examinations that are performed.
  • International Classification of Diseases (ICD-10) - These types of codes are used to identify medical diagnoses.
  • Healthcare Common Procedure Coding System (HCPCS) - Codes not referenced in the two bullet points above.  This may  include medical devices and non-physician services.

For each code to be used correctly and placed in billing software, the coder must follow specific guidelines.

What goes on in Medical Billing?

Once the coding is finished, the billers put together an invoice to send to the patients’ insurance company, which is also known as an insurance claim. Once the insurance billing is settled, the remaining balance will be invoiced to the patient. This process is also the responsibility of the medical billing specialist. Medical billers can:

  • Generate invoices
  • Determine copay requirements
  • Track the payments
  • Follow up on payments from insurance companies and patients

What Does a Medical Billing and Coding Specialist Do?

A medical billing and coding specialist is responsible for verifying patient information including medical history, symptoms, exams, test results, treatments, and other information that may be relevant to their providers (1). Day to day, these professionals typically do the following:

  • Review patients’ records for timeliness, completeness, and accuracy
  • Organize and update information in clinical databases or registries
  • Use classification systems to assign clinical codes for insurance reimbursement and data analysis
  • Electronically record data for collection, storage, analysis, retrieval, and reporting
  • Maintain confidentiality of patients’ records (1).

Keep in mind that there are two types of medical billing, and while some things may be similar the way they bill may be different.

Medical Coding and Billing Job Growth

As the current population grows, the aging population will need more medical services. This will require more medical billing and coding specialists to help arrange and systemize this additional health data.

Where Do Medical Coding and Billing Specialists Work?

Medical Billing and Coding Specialists commonly work in medical environments such as:

  • Physicians’ offices
  • Hospitals
  • Nursing care facilities
  • Outpatient care centers

Get started now! Contact us today to learn more about out Medical Coding and Billing Program. 

What Do I Need to Become a Medical Coding and Billing Specialist?

A high school diploma or equivalent and experience in a healthcare setting are enough to qualify for some positions in the field, but others may require postsecondary education.

Postsecondary or non-degree programs typically include courses in the following:

  • Medical terminology
  • Health data requirements and standards
  • Systems of the human body
  • Keyboarding
  • Medical insurance billing and reimbursement
  • HIPAA and the legal medical record
  • Physician coding and compliance
  • Claims processing
  • Billing and reimbursement for providers such as Medicare, Medicaid, and others
  • ICD-10 CM and CPT
  • Coding compliance
  • Exposure to medical law and ethics
  • And more!

Medical Billing and Coding Specialist Program | Bridgeport & Danbury, CT

If becoming a medical billing and coding specialist is something that interests you, look no further! At Training Direct, our Medical Billing and Coding Specialist program is designed to help you prepare for your introduction to healthcare. We combine real-world training and classroom instruction to build your knowledge and skills in the field.

Our medical billing and coding training at both our Danbury and Bridgeport, CT locations can be completed in as little as 4 weeks! The instructors at Training Direct are committed to your success and want to help you live out your dream of becoming a medical billing and coding professional.

Once you’ve completed the program, you are eligible to sit for a National Certification Exam. We also offer day, evening, and weekend medical billing classes so that you can attend classes at a time that works best for your schedule.

Our job is to help you succeed! Click here for more information and enroll today!

Sources:

  1. https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-2
  2. https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-6