Medical billing and coding represent the essential non-clinical job roles serving the healthcare system. From encoding the patient’s essentials to translating them into a bill for pricing through the health plans or patients, these specialists play a vital role. Therefore, learn effective strategies for medical billing and coding to excel in your career pathway.
Let’s explore the optimal services and integrated roles of medical billers and coders. How do they serve the healthcare industry, and what is the pathway to embark upon this journey? This blog will remove all your confusion.
What is Medical Billing and Coding, and Who are Medical Billers and Coders?
Billing and coding form an essential part of any organization or industry. The same is true for the healthcare industry. Medical coding refers to the process of translating complex medical diagnoses, procedures, and services into standardized codes. These codes communicate critical information about patient care, diagnoses, and treatments in a universal language understood by healthcare professionals, insurance companies, government agencies, and other entities involved in healthcare management, billing, and research.
Medical billing is the process of decoding the codes assigned by the medical coders. These then take the shape of the bill sent to the insurance companies for a claim or to the patient directly. It involves the systematic creation, submission, and follow-up of claims to ensure healthcare providers to reimburse for the medical treatments, procedures, and services they provide.
How to Pursue a Career as a Medical Biller and Coder
Let’s explore a systematic approach to securing employment as a medical biller and coder. Here’s a comprehensive guide:
Enroll in an Accredited Undergraduate Program
Identify an institution offering accredited programs in medical billing and coding. According to the Bureau of Labor Statistics, individuals in this field typically pursue postsecondary education, often in the form of an undergraduate certification.
Successful Completion of the Certification Program
Upon enrolling in an accredited program, focus on completing your undergraduate certification. You can leverage various educational platforms to expand your knowledge base.
Attaining Relevant Certifications
For those aspiring to become medical billers and coders, it is advisable to acquire one of three available certifications:
- Certified Professional Coder (CPC)
- Certified Coding Associate (CCA)
- Certified Coding Specialist (CCS)
You can obtain these certifications by passing specialized medical billing and coding certification examinations.
Exploring Potential Career Opportunities
After completing your education and obtaining certification, the next step involves seeking out suitable job prospects. Seeking advice from experienced professionals or exploring job boards tailored to your specific requirements can be valuable in this regard.
Medical Billing and Coding Skills
Acquiring the essential skillsets enable you to excel in your career and makes you a perfect fit for the open positions. Medical billing and coding require specific skillsets to succeed in this field:
- Attention to detail: The coding and billing system require prime attention, as the analysis is for five or six-digit numbers. Numerical errors may cause financial losses or claim rejections.
- Medical Terminologies; When associated with a healthcare background, in-depth knowledge of medical terminologies is necessary to uplift your career. Knowing these, you can understand the medical interventions that the patient went through and assign the correct codes.
- Technological proficiency: Technology has replaced human counterparts in every possible transaction done today. It increases efficiency and reduces the possible errors resulting from manual handling.
- Organizational skills: The task of medical billing and coding can be overwhelming at times. Therefore, organizational skills help you smoothly assemble them to reduce the workload and ensure efficient workflow.
- Data analysis: Analyzing data is essential skill when dealing with human data. A huge amount of numbers need an expert-level analysis to assess the data to check if it makes sense.
Types of Codes Used in Medical Coding
The codes should be universal so everybody can understand them and utilize in their systems. The three types of codes used for coding are:
Current Procedural Terminology (CPT)
These codes are developed by the American Medical Association. They assist with services provided by a physician or clinic.
Healthcare Common Procedural Coding System (HCPS)
HCPS coding systems were developed by the Centers for Medicare and Medicaid Services. These codes determine hospital services, medications, and supplies.
International Classification of Diseases (ICD)
It is an essential coding system developed by the World Health Organization. It represents a universal coding system for health statistics.
The field of medical billing and coding is constantly evolving. With the latest technologies and trends penetrating the market frequently, billing and coding are also elevating to a new height. The driving force behind these changes is the advancements in technology, changes in healthcare practices, and shifts in regulatory and reimbursement policies.
Telemedicine is taking over the healthcare delivery real soon. Therefore, medical billers and coders should adapt to this incoming change and take on the online version of billing or coding accurately.
The time is arriving soon when data analytics and artificial intelligence will intervene deeper in billing and coding. AI-powered tools can assist in automating the coding process. It can identify and reduce the frequency of coding errors and predict reimbursement outcomes. This way, the efficiency, and accuracy will boost to a whole new level.
Predictions say that the healthcare industry will transition from ICD-10 to the ICD-11 coding system. This transition will require coders and billers to undergo training to familiarize themselves with the new coding guidelines and terminology.
To conclude, medical billing and coding is a growing career option in the healthcare industry. Although both serve as non-clinical roles, billing and coding form a major component of the financial system. Medical coders use specific coding systems to assign alphanumeric codes to the healthcare experiences, a patient encounters during his stay. Medical billers decode them and present the bills to the health plans or the patients for payment. They show a positive outlook for the coming future. Therefore, discover healthcare jobs and get started with your career.