What is Medical Billing and Coding?

Health information technology is an important part of the healthcare system

Have you seen job postings for medical billers and coders? Do you have friends who are going to medical billing and coding schools? Medical billers and medical coders are important to the healthcare industry. They do behind-the-scenes work that helps to keep hospitals and doctors’ offices running smoothly. But what exactly do medical billers and coders do?

Medical billers and coders are responsible for processing and submitting health insurance claims to private insurers, Medicare, and Medicaid. In other words, they help to make sure that doctors get paid for the services that they provide. They help to make sure that your insurance company pays its part of the bill.

Getting trained as a medical biller or coder does not require a college degree. Most training programs can be completed in just one year. Continue reading to find out more about this important job field.

What Medical Coders Do

Medical billing and medical coding are two separate functions, but most training programs will teach you how to do both. Medical coding is the first step of the process. Medical coders are responsible for assigning specific codes to the diagnoses and procedures that patients receive. For each patient chart, the coder must assign the correct codes, and then use these codes on the insurance claim forms. In this role, you might:

  • Choose the correct procedure codes using the system called CPT, or Current Procedural Terminology.
  • Choose the correct diagnosis codes, using the system called ICD-10, or International Classification of Diseases.
  • Assign these procedure codes and diagnosis codes to a patient’s chart and insurance claim forms.
  • Enter codes and other patient data into electronic health record systems.
  • Review claims to ensure that the coding was done correctly.
  • Help keep patient files and histories up-to-date
  • Interact with staff members to sort out any codes that may be incorrect or confusing

Being a medical coder requires that you value accuracy. Sometimes it is not always obvious what codes to select, and coders have to take the time to determine the best code to use so that the insurance company pays the claim. Medical coders also have to be comfortable with computer software so that they can work quickly to process the claims throughout the day.

What Medical Billers Do

Medical billers are responsible for a different part of the process. They work in the billing department to send out bills and ensure that payments and reimbursements are being made on time. As a medical biller, you would be responsible for:

  • Entering insurance claims into specialized billing software to submit it to insurers
  • Ensuring the accuracy of claims before you submit them
  • Interacting with patients about their insurance and what is covered or not covered
  • Contacting insurers to find out why a payment is late
  • Reviewing receivables records to make sure that reimbursements have been made properly
  • Staying current with the latest in insurance and reimbursement procedures

These skills require that you have a keen eye for detail. Medical billers need to be careful and accurate, and they need to stay organized to keep on top of late and missing payments.

If these job tasks sound interesting to you, then going to medical billing and coding school could be a good choice for you. Find out more about this field at 5 Things to Know about Becoming a Medical Biller or Coder. You never know…this could be the start of a new career for you!


The American College of Medical Careers offers a medical billing and coding training program at our campus in Orlando, Florida. Find out more about our school by contacting us online. We would be honored if you chose ACMC for your career training.