Are you interested in making a career in medical billing and coding career path? (Or) Just curious to know about the career perspective of medical billing and coding career path. This article provides you with every possible detail of medical billing and medical coding career path; How to start and where to start?
Medical billing and Medical coding career option are for those candidates, who don’t want to study any further after passing high school.
Why you should choose medical billing and coding career path
You will get these following benefits if you are choosing medical billing and medical coding career path…
 No Stress: In today’s modern world, there are very few jobs that are stress-free; medical billing and medical coding are one of them.
 Fix Timing: These days working overtime is common. But in this career path if your timing is 9 to 5 (8 hours shift), then it is 8 hours of a shift. You don’t have to work for a late night or stay for few hours after shift end. Fix days working; usually, medical biller and coders are working 5 days in a week.
 No Degree required: Yes! You absolutely not required any higher education for medical billing and medical coding career path.
 Business: You can start your own business after getting experienced and skilled in medical coding and medical billing. You can also do your job at sitting in your home (work from home).
What is Medical Billing and Medical Coding?
Medical billing and Medical coding are two different terminologies in healthcare facilities. Therefore we have to separate these two terms to know what it means. So, let’s first understand the Medical Coding.
What is Medical Coding?
What comes to your mind when you first hear the word ‘Medical Coding’? Is it related to coding; which is IT professionals use to build a software and program? No! Medical coding is not related to that lengthy programming and coding. This coding is completely based on the numeric and alphanumeric coding system.
Medical coding is the study of the numeric and alphanumeric coding system of the anatomy, disease and medical procedures. These alphanumeric coding systems define a specific code for every healthcare related issues in the body. For example:
Code for the fever is 10JM3.7D
Code for the joint pain 7465F.TS6
A Medical coder translates the doctor diagnosis, prescription, or any other followed procedure report into the alphanumeric code.
For every symptom of the body, there is a specific code defined. Therefore a medical coder has to fill the exact code that symptoms are shown by the patient. Because a wrong code can affect the claim status in a bill, that will go to the insurance company.
What is Medical Billing?
As the name implies billing, means prepare and make a bill. A Medical biller made a bill according to the information given by the medical coder. After preparing the investigation report (bill) in a proper structure; medical biller has to send the bill to the insurance company in order to receive payment for services rendered by the patient.
Medical billing and coding are used to maintain the healthcare data of the patient, electronically for the insurance companies.
Why we need Medical billing and coding professionals?
Now you would think is there any need to get doctor diagnoses and the prescription report has to be code. You are right we don’t need medical biller and coder to manage hundred and thousand patient. But as you know the population of earth is in billions and so too many diseases human body has. Therefore the vast majority of people has medical insurance because of the health concern.
If you have to manage all the patient data and health-related diseases at great scale (In Billion). Then you definitely need some parameters to define, which is applicable everywhere and easy to know the exact symptoms and diseases of a patient.
It makes easy to extract the accurate information of the patient and disease he/she has. A biller makes a proper report (called bill) about the health-related issues for the insurance company. So using the billing information insurance company know, what is the exact reason a patient is claiming for.
Medical billing and coding make healthcare system easy and efficient.
Education required to become a Medical biller and coder specialist
Education 1 (Mandate): You must have completed your high school [Subject must have: Biology and Mathematics] to make a career in Medical billing and coding career Path.
Education 2 (Mandate): Certification or Diploma or Associate Degree in Medical billing and coding
These two are the very common and highly recommended certification by most of the medical biller and coder specialist. Therefore to start a career in medical billing and coding these two certifications are suitable to get.
Certification is not necessary to get employed in medical billing and coding domain. The only thing you need is the skills set.
However, certification makes you more approachable for the job. Therefore certifications provide you more opportunities as compared to other not-certified medical biller and coder.
After clearing the above certification you can also go for these certifications; to get lucrative salary package and for better designation.
Certification in Medical Coding
- Certified Outpatient Coding (COC)
- Certified Inpatient Coder (CIC)
- Certified Risk Adjustment Coder (CRC)
- Specialty Medical Coding Certification
Certification in Medical Billing
- Certified Professional Medical Auditor (CPMA)
- Certified Documentation Expert Outpatient (CDEO)
- Certified Professional Compliance Officer (CPCO)
- Certified Physician Practice Manager (CPPM)
- Instructor Certification
These following certifications generically require 1 to 3 years’ experience in healthcare facilities.
What will you learn in Medical billing and coding career path?
- The medical terminology of human body, disease, medicine, doctor procedures and other healthcare facilities terms.
- The international coding guidelines
- Various types of insurance
- Billing regulations, methods and policies
- How to effectively apply billing to get reimbursement.
Skills needed to make Career in Medical billing and coding
- International Classification of Diseases (ICD) Codes
- Current Procedural Terminology (CPT) code set
- Healthcare Common Procedure Coding System (HCPCS)
- Medical Terminology: Language of Medicine (LOM)
- Basic knowledge of Pathology and Physiology
- EMR (electronic medical record)
- EHR (electronic health record)
- Medical billing forms
- Insurance companies policies
To learn the above skills set you can either go, for some training institution (online + offline) or you can learn by yourself.
- Computer and Typing Skills
- Communication Skills
Medical biller and coder Job Description
- Identify the specific and accurate code for diagnosis. And assign the exact code for disease, symptoms and the condition of the patient.
- Sequence all the defined codes in a proper manner to get more reimbursement.
- You have to keep track of the patient healthcare data and paperwork involved with medical procedures. And Deals with the bills denials, rejection and claim errors at the insurance companies end.
- As a medical biller, you have to make sure all the information related to payment and other necessary details is flowing efficiently in between the insurance companies and the hospitals.
- You act as a gateway in between medical service providers and insurance companies. Therefore you have to communicate to the insurance companies on behalf of the hospital or clinic, where you are working.
- You have to manage all the billing transaction and accounting related information of the patient seamlessly and efficiently.
Medical billing and coding Career Scope
Healthcare is one of the largest and fastest growing industries in the world. Consequently medical insurance companies. Therefore hospitals and healthcare companies required billing and coding professional to reimburse the payment from the insurance companies.
Maintaining the EHR and EMR of patients, so that they get paid off seamlessly by the insurance companies increasingly becomes an essential part of the healthcare industry.
Especially in India. The country is in developing stage and same applies to the Indian healthcare industries, they are trying to implement medical billing and coding. For the Indian student, it is the right time to start a career in medical billing and coding.
According to indeed.com, there are more than 20,000 jobs posted every month in the USA. And in India, it could be more.
So if you are looking for a career that not required a higher degree; and also have a nice future scope. It might be a good career option for you to opt.