Medical Billing and Insurance Coding - Overview

Medical Billing and Insurance Coding specialists play a very important role in the health care industry. As health care providers change from paper files to computerized files for patient records and billing, trained Medical Billing and Insurance Coding professionals are needed to handle this data. They are responsible for making sure insurance companies and patients are billed correctly for the health care they receive. Employers of Medical Billing and Insurance Coding specialists include doctor offices, hospitals, clinics and other health care providers, insurance companies, and attorneys/law firms dealing with medically-related lawsuits.

Often referred to as a single term, Medical Billing and Insurance Coding are actually two separate career paths. While some employers combine the roles into one position, larger facilities (most hospitals) employ specialists in each area.

What is Medical Billing?

Medical billing specialists are responsible for making sure the health care provider gets paid correctly. To do this, they enter data regarding the services performed by the health care provider into a medical billing software program. They often prepare statements for mailing, run reports to show which accounts have been paid and which are past due, and work with patients and insurance companies to ensure timely payment. Skills required for this profession include familiarity with medical terminology, anatomy, reading coding languages, and strong communication and people skills.

What is Insurance Coding?

Every medical diagnosis or procedure must be assigned a code in order to ensure proper payment to the medical provider — this includes everything from a headache to triple-bipass surgery. It is the responsibility of the medical coder to assign the proper code to each procedure. To do this, the coder may conduct research to identify which code should be used and to determine if several procedures can be ‘bundled’ together into a single code.

The coding specialist must also recognize any inconsistent notes in the patient chart and therefore should hold a very high degree of knowledge in anatomy, physiology, medical terminology and disease treatment. Other skills required for a successful career in Insurance Coding include a thorough understanding of coding languages, problem-solving and critical-thinking for data analyzation, organization, self-direction, and exceptional attention to detail.

Medical Billing and Insurance Coding - Is it for you?

A career in Medical Billing and Insurance Coding is perfect for the person who wants to pursue a challenging office position in the health care field. Insurance coders must be able to analyze data, pay attention to detail, and be organized and able to work independently. They may also speak with insurance companies and patients to help the billing process run smoothly, so customer service skills are important. This career choice typically offers tremendous job stability, growth potential and benefits package.