What Does a Medical Coder Do?

Medical billing and coding specialists are important to the healthcare industry

If you are thinking about career training, one of the quick-start careers that you might be considering is becoming a medical billing and coding specialist. But before you jump head-first into a new career field, it helps to think about whether the career is a good fit for you. Ask yourself these questions:

  • Do you picture yourself working in an office job?
  • Do you like to work at a desk, on a computer?
  • Are you detail-oriented?
  • Would you like to be part of the healthcare industry?

If you answered yes to these questions, then you may have the traits that are important to becoming a medical billing and coding specialist.

Let’s find out more about what this profession is all about. This article will answer questions like: How do you get medical billing and coding training? What do medical coders and medical billers do on a typical work day? How is the work environment? How much do medical coders and medical billers make?

How do I get trained?

One of the great aspects of becoming a medical billing and coding specialist is the quick start career training. While some jobs in the medical/nursing field require many years of training, this field does not. Most training programs can be completed in less than one year, providing you with marketable medical billing and coding skills and getting you on the job market quickly.

What is a typical work day for a medical coder?

Medical coders have an important role in the healthcare field. They are responsible for assigning specialized codes to each service/procedure/diagnosis that a patient receives. These codes are then used to determine how much of the cost will be reimbursed by the insurer.

Throughout the course of a typical day, medical coders will receive a batch of patient notes (also called billing sheets) that need to be evaluated and coded accurately. Each patient note needs to have the correct codes assigned to it. The medical coder begins by reviewing the documentation to look for the patient’s diagnosis and any procedures that were performed. With these diagnosis and procedure notes, the coder can assign the appropriate alpha-numerical code, from specialized coding systems called the International Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT-4).

Sometimes the codes are fairly simple to assign, for instance if the patient received a very common procedure. Other times, finding the right code can require extra analysis and consultation with other coders to get their advice. Once the coder has decided on the appropriate code for the diagnosis and/or procedure, they enter it into the computer system and move on to the next patient record.

The process of reviewing patient notes, looking up codes, assigning codes, and entering information into the computer system continues throughout the work day. Over time, medical coders get more efficient at their work and can process patient notes more quickly.

What is a typical work day for a medical biller?

While most people learn both medical billing and medical coding skills during their training, it is usually two separate jobs. If medical coders are responsible for assigning the correct codes, what does a medical biller do? Medical billers are responsible for submitting health insurance claims to the third-party payers. This could be insurance providers, government programs like Medicaid and Medicare, or directly to the patients. They are also responsible for collecting and processing the payments (reimbursements) when they arrive.

A typical day for a medical biller involves working with patient claims after the medical coder has assigned the codes. Billers submit the claims to private insurers or government programs. They need to use special billing software to enter the information. Medical billers are also in charge of the payments as they come in, and need to process them according to their employers’ instructions.

Like in many jobs, things don’t always go smoothly! Sometimes claims are denied and the biller will have to follow up to determine why the claim isn’t being paid. They may even have to make a formal appeal of the claim to help convince the insurer to pay the reimbursement.

How much do medical billers and coders make?

The AAPC, or American Association of Professional Coders, provides a webpage detailing, on average, how much a medical coder makes, depending on your region of the country. Another place to learn about salary expectations is the Occupational Outlook Handbook’s section on pay for medical records and health information technicians.

Where do medical billers and coders work?

Hospitals, doctors’ office, insurance agencies, and other health-related offices hire medical billers and medical coders. In small facilities, you may be expected to handle both the billing and the coding processes. In bigger institutions, the positions are usually separate.

Sometimes you will have your own desk, and other times, there may be another person who shares it with you, who works a different shift. Most of your day will be spent on the computer, and you may have a certain quota (number of bills) to complete each day.

Depending on the facility where you work, there may be many other employees doing your same kind of work. One of the advantages of working in a big institution like a hospital or health system is that you will have other medical billers and coders to learn from. On the other hand, working in a small facility like a local doctor’s office can also have its advantages, if you enjoy smaller, quieter work environments.

What are the advantages of choosing this career field?

People are choosing to go to medical billing and coding school for a number of different reasons. Here are some of the advantages of this field:

  • The career training is just about one year
  • A quick start career choice makes a lot of sense for people who need to get marketable skills sooner rather than later
  • Working in the field of healthcare is challenging and personally gratifying
  • The work environment is professional and courteous
  • The job outlook for medical billing and coding specialists is positive, according to the Occupational Outlook Handbook

Where can I find out more?

To learn more about this field, try these resources:

An Overview of the Medical Billing and Coding Profession

American Association of Professional Coders

Five Things to Know About Being a Medical Biller or Medical Coder

Reasons to Become a Medical Billing and Coding Specialist

We hope this article has helped you understand this career path. If you are interested in finding out more, contact the representatives at the American College for Medical Careers in Orlando, Florida. It’s easy to begin. Just fill out our online form, give us a call at 407-738-4488, or schedule a tour. We hope to see you at ACMC!