Trade Schools with Medical Billing and Coding Programs
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The medical payment process is complex and demanding. Because of this, those working medical billing and coding jobs play a crucial role in the field of healthcare. Doctors and hospitals rely on these people in order to receive compensation for their work.
Diagnosis and treatment data needs to be accurate when sent to insurance providers. In order for this to happen, health information technicians take on a number of responsibilities. Billing and coding duties are often split up between separate workers to make the process more efficient.
What Is Medical Coding?
People in medical coding jobs decipher patient information into shorthand used by physicians and insurers. In order to perform this task, they review the doctor’s notes and interact with medical assistants. To convey what has happened during a screening, workers apply tailored codes to patient records. At times they will need to translate client charts and health histories.
Medical coders work closely with nurses, physicians, and receptionists. They monitor patient data to track changes in health. They may also need to apply procedure codes to operative reports utilized during surgeries. In order to maintain their merit, these workers must keep up with the industry’s latest coding updates and standards.
Workers use electronic medical record software for data entry purposes. The content they input is given to the people with medical billing jobs who send it to insurance companies or other payers.
When claims are denied, they need to conduct chart audits to confirm medical history. For this reason and many others, workers must ensure consistency and accuracy in the information they process. Depending on several factors, coders may need to adhere to one of three standards:
- ICD is the International Statistical Classifications of Disease. It’s used to accurately categorize diseases, diagnoses, and treatments. Physicians use it across the nation, and the World Health Organization provides updates as needed.
- Current Procedural Technology, or CPT, is the language of the American Medical Association. Revised annually, the system is in use throughout the industry. Similar to ICD, it conveys surgical and diagnostic data to insurance providers and physicians.
- Used by Medicare and Medicaid, HCPCS stands for the Healthcare Common Procedure Coding System. It’s modeled after CPT and is maintained by the Centers for Medicare and Medicaid Services. HCPS provides a reliability when submitting claims to government-sponsored healthcare programs.
What Is Medical Billing?
Billers must complete insurance claim applications while following strict guidelines and procedures. They ensure compliance of payments and contact insurance companies to resolve errors. They produce accounts receivable reports and contact patients or payers for claims. Another duty involves looking through the explanation of benefits forms to confirm payment from insurers.
Before sending out claims, people working medical billing jobs double check the work of coders to ensure precision. Billers check the accuracy of patient invoices and complete missing or incorrect fields. They seek payment of unpaid claims in a timely fashion and ensure compliance of insurance payments. Sometimes they may need to arrange payment plans for patients and analyze or petition denied claims.
Not only do they input rate changes into specialized software, but billers also compile collection reports and update spreadsheets. They keep track of customer payments and invoicing data. At times, they need to answer patient or insurer questions over the phone. When denied claims come around, billers must find out what happened and decide how to resubmit.
Ultimately, medical billers are responsible for doctors and patients receiving payment from insurers. To verify reimbursement of claims, workers follow up with insurance companies, healthcare practitioners, and individuals. This requires superb organization and time management skills.
What Are Useful Skills for People in This Field?
- Comprehension of medical terminology
- Excellent communication, speaking, and customer service skills
- An understanding of payer requirements and insurance guidelines including Medicare, Medicaid, and HMO/PPO
- Knowledge of ICD, CPT, and HCPCS coding
- Experience with bookkeeping and accounting
- Understanding of computers and calculators
- Problem solving and critical thinking abilities
- Positive demeanor and composed attitude
- Ability to multitask and handle stressful situations
- Ability to communicate with a diverse range of people
- Capable of delegating tasks and engaging in conflict resolution
Are There Requirements for Medical Billing and Coding Jobs?
Job criteria may vary. Besides a high school diploma, a medical coding certification or degree is usually required. Associate degrees are often preferred, but vocational courses can also prepare workers for entry-level positions. Many medical coding schools offer the necessary credentials.
Success in this field depends on a solid understanding of medical terminology. Previous employment in a clinical office is preferred. For billers, a degree in business administration or accounting is a plus.
Recruits should have an understanding of medical coding software and the inner workings of health insurance. They should be organized individuals with knowledge in health record maintenance. This is why quality medical coding training is so important for job hopefuls.
What Is the Outlook for
Medical Billing and Coding Jobs?
The demand for skilled billers and coders is on the rise. People in this field can find medical billing or medical coding jobs everywhere from single-provider practices to giant surgical centers. Open positions are in hospitals, clinics, physician’s offices, and home health care companies.
The medical billing salary begins near $26k and averages out around $33k. This may increase to as much as $45k depending on proficiency and experience. Perks often include the following:
- Bonuses and special incentives
- Profit sharing programs
- Paid time off and holiday pay
- Dental, eye, and healthcare coverage with low deductibles
- 401(k) retirement plan with company match
Those working for large clinics and hubs generally earn more than those employed by smaller practices.
What Should Workers Expect?
Coders must be sharp thinkers with good memories. A big part of their job involves reading patient reports to gather detailed health history info. Sometimes they have to translate medical coding for others to understand.
Those who choose this profession interact with medical professionals daily. Typical duties involve reviewing benefits, confirming patient eligibility, and obtaining treatment referrals. With so much money on the line, workers must be precise while interpreting patient records.
Can You Work Remotely?
Some medical billing and coding jobs give employees the chance to work from home. A health care facility sends them the necessary info electronically. The coders then do their interpreting and data entry remotely.
These employees must follow health privacy laws the same way they would in an office. It is important to maintain the safety of medical records and other patent information.
Do Billers and Coders Have Any Other Options?
Knowledge in medical billing and coding may lead to a career as a cancer registrar. In this role, workers apply specific codes to convey tumor diagnosis and treatment methods. They ensure correctness of patient records by reviewing pathology reports.
Similar to standard coders, registrars keep track of cancer treatment through yearly checks. They gather client information for analytical and research purposes.
There are several other options for people with this skillset. Billers and coders can move into more focused roles such as reimbursement specialists, patient account representatives, and claims assistants.
Question and Answer: Medical Billing & Coding
Q&A session with a medical coding clerk, Melissa Wright, who works in Houston, Texas.
Q: Can you tell us who you are currently employed with?
A: I work for Dr. Ashmir at his offices in Houston, Texas and I am a medical coding clerk.
Q: What is the most requested service you provide?
A: Well, Dr. Ashmir has a busy family practice health clinic and I make sure the different services he provides are then paid for by insurance and government agencies.
Q: How long have you been a medical coding clerk?
A: I have been doing the coding at the office for three years. I started in the reception area 7 years ago after graduating high school.
Q: Can you tell us a little about your training and school experience?
A: I had been working for Dr. Ashmir for a few years already, working with the patients prior to and after seeing the Doctor and I wanted a way to make more money but at the same office. So, I spoke about it with Dr. Ashmir and he suggested that I look at learning how to do medical coding and he would be sure to give me a position if I completed some school first. I enrolled in the AHCP Academy of Health Care Professionals here in Houston and completed my courses there before I began to work in the coding office.
Q: What’s your favorite part about having you position, and in contrast, what is the worst part?
A: The best thing about my position is that I am now able to earn more than I did before at reception. I’m making more per year now and I have an opportunity to do work for other doctors’ offices here in the medical building.
Q: Tell us about an average day.
A: When I come to the office at 8AM there are a number of patient files that I have to go through. I do my normal organization so that once I’m done I can put the information back where it came from in the office. Once I begin to go through the appointment procedures and notes from the doctor. The diagnostic coding that is done for us to request payments gets completed from the files that we keep here. The process is pretty regular at our office because of the amount of patients we see. Beside our lunch, we are collecting information and preparing it for processing by the companies who are responsible for payment. There will be a number of calls to our department from those who are interested in the information in the files. We report on the files when requested and if the request is warranted. I usually leave the office about 5:15 PM, having closed the work I was in the process of doing around 4:30.
Q: If you ever take the next step in business, what would that be?
A: The reason why I went to school was because I wanted to make more money. I like the people I work with and the people I work for. If I would want to add anything to that, I can always take on more work at home.
Q: Did your previous work history have anything to do with your current business position?
A: I love working in the doctor’s office where I am now. It was the reason I began doing what I do now. So, I would say that my job experience kept me wanting to be in a position where I could make more money and have extra responsibility than I had in the beginning.
Q: In your field of work, what kind of benefits do you receive?
A: We get a great insurance program plus sick and vacation time that accrues throughout the year. I had a total of three weeks of vacation this year and I did not even use all the time I had available. The coding that I do for other doctor’s hear do not give me anything in benefits except a chance to earn more money.
Q: Tell me about the money you make.
A: This year I will earn $34,000 from Dr. Ashmir. Last year I added $9,000 from the extra work that I did for other offices.
Q: What makes someone good at this profession?
A: Attention to detail, the ability to determine well the files that they are handling, and an ability to communicate about the files and the billing as they have been trained.
Q: Would you recommend this career path to others who are looking for the same things you were when you started?
A: Oh yes. I am happy that I spent the time to get some extra education to build a better career. I hope that anyone who does this can be as happy as I am where I work.