What Is a Medical Billing & Coding Specialist?
A medical billing and coding specialist assigns numeric or alphanumeric codes to identify diagnoses and medical procedures on patient records, using industry-established classifications. The coding allows insurance companies to process claims and make payments accurately. This work is becoming increasingly complicated and requires diligent accuracy as well as occasional requests to physicians for clarification.
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Geography
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Medical billing and coding specialists most often work in the finance department of a hospital, but increasing opportunities are available in private physicians' offices and clinics, including those of dentists and psychiatrists, as well as nursing care facilities, non-profit organizations, and third-part billing companies. Some hospitals and clinics offer employees the opportunity to work remotely from home. Because of their extensive knowledge of coding, these specialists also work for government agencies and insurance companies. Some even work for international health organizations, studying costs of health care and geographical patterns of illnesses.
Identification
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The medical coder has more complicated work than simply looking up diagnoses and treatment procedures in coding manuals. He is working from documentation by physicians and other health care personnel, including notes, charts, and laboratory results. Sometimes there is no single straightforward diagnosis, and there may be multiple forms of treatment. With increasing types of laboratory and other diagnostic tests, as well as medical procedures, coding specialists have a complex job. Occasionally they must contact physicians for further information. Once all the classifications are assigned, the medical billing and coding specialists enter information into a computer database.
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Features
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Some medical billing and coding specialists are trained on the job, but most employers prefer certification before hiring. An individual interested in this career can obtain a certificate at a vocational school or through an on-line program. Coursework includes study of billing software and medical terminology, analysis of medical records, anatomy and physiology, and the two standard classification manuals.
Types
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The Classification of Disease Manual and the Current Procedural Terminology manual are the books which the medical billing and coding specialists use in their work. Specialists who work with Medicare or Medicaid also need proficiency in the Healthcare Common Procedure Coding System. Coders are not expected to do a great deal of memorizing because there are so many codes and the manuals change frequently, but often these specialists do remember a great deal of classifications simply from working with them so consistently.
Benefits
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The median annual income for medical billing and coding specialists is around $31,000, with the starting hourly wage at around $11. With five years experience, hourly wage ranges from about $14 to $19. Coders who specialize in certain fields such as nephrology and rheumatology make significantly more, as do those advancing to supervisory and coordinating positions.
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