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Medical billing and coding specialists work in one of the fastest growing professions in the United States. These workers include medical secretaries under the U.S. Bureau of Labor Statistics (BLS); Overall, this sector has a projected job growth of 8% between 2021 and 2031, resulting in 53,600 new jobs. Demand is expected to increase with the aging population’s need for more health services.
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How To Learn Medical Billing And Coding At Home
Every health center needs someone to handle medical billing and coding for insurance and patient receipts. Physicians or office managers may perform these tasks in addition to their other responsibilities, or they may hire one or more employees to perform these tasks. Since clinical staff are focused on patient care, it often falls to trained professionals to handle the important administrative work of billing and coding to ensure that health care providers are paid for their services.
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Does the idea of working as a billing and coding specialist appeal to you? Let’s take a look at what it takes to make it in this fast-growing industry.
A billing and coding specialist helps the healthcare facility manage insurance claims, invoices, and payments. The daily work of a Medical Coding and Billing Specialist includes:
While these workers often work in the same healthcare facility where patients go for treatment, it is primarily an office job as opposed to patient-facing clinical work. A medical billing and coding specialist will spend a lot of time reviewing, entering and updating information on the computer.
Job descriptions often combine billing and coding in a single position. However, these are technically two different job roles, each with their own responsibilities and duties.
Medical Billing And Coding Career Guide (2022)
Most healthcare offices will hire the same person to do both jobs, although larger facilities may split the job into two separate positions—so it’s important to understand the difference between the two roles.
Medical coding is the act of taking a provider’s diagnostic and procedural notes and converting them into the correct codes for record tracking and billing purposes. Codes are industry standard alphanumeric combinations used to identify services provided and billed. This will require knowledge of the various codes used:
Each of these codes is used in insurance billing, and the coder must follow specific instructions for proper use and placement in the billing software.
Codes may be entered as soon as the patient makes an appointment. Visit type and symptoms will be patient-reported codes. Other codes will apply to symptoms observed by medical staff, tests and procedures performed, diagnoses, and treatments prescribed.
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After coding is complete, medical billing specialists create invoices and send claims to patients’ insurance providers (or other payers). Based on these codes, insurance companies will approve or deny payment requests. Any remaining amount not covered by insurance will then be sent to the patient for payment.
The billing process often begins when the patient meets with the medical office, as codes can be entered and submitted to the insurer for pre-approval. This helps determine what the patient’s out-of-pocket costs will be, so the office can charge the patient for that amount at the time of the visit.
A medical biller must know the industry codes even if someone else is coding, because the billing specialist must review the reasons for any denied insurance claims and may be responsible for updating the codes before resubmitting claims. A medical biller will also verify that the codes are entered correctly before submitting the initial claim.
Once the insurance bills are settled, the remaining balance will be billed to the patient. This process also falls to the medical billing specialist. The medical biller also determines co-payment requirements, tracks payments, and tracks outstanding payments from insurance companies and patients.
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If a bill is not paid, the billing specialist should contact the insurance companies and make sure all the paperwork is in order. If a patient does not pay for an outstanding bill on time and does not respond to other requests, the billing specialist may need to turn the debt over to a collection agency.
Because the billing and coding processes are intertwined, many medical offices hire billing and coding specialists with training to perform both roles. While some larger facilities will hire separate teams to take care of billing and coding, these individuals generally work very closely together to ensure that the process is done correctly. The most important aspect is avoiding billing and coding errors so payments are collected on time.
While job titles and descriptions may vary for medical billing and coding specialist careers, the basic requirements will often be the same. Familiarity with essential codes is a common requirement, but there are other areas of knowledge that can enhance employability.
To code correctly, a basic understanding of medical terminology is essential. This includes anatomy and physiology terms, diagnostic and procedural terms, etc.
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You will be able to do the basic math to determine the appropriate billing amount. While the billing system may automatically fill out forms with the appropriate amounts for insurance claims based on the codes entered, you may need to calculate patient balances or set up payment plans where applicable.
The medical billing and coding process requires a working knowledge of computer systems and related medical software. Ability to learn new programs is also a plus.
Part of the medical billing process may involve contacting patients for payment. The ability to communicate effectively and professionally is essential for this aspect of the job. Some patients may be stressed, depressed, or angry when faced with medical problems and a large bill, so good communication skills can make these conversations a little easier.
In addition to the level of computer proficiency, a medical billing and coding specialist will need to use other basic equipment, such as a 10-key calculator, printer, copier, scanner, telephone system, etc. If you’ve ever worked in an office setting, you’ve likely used these tools.
How To Start A Medical Billing Business From Home! Webinar *replay*
While certification is not required by every employer to get a job as a medical billing and coding specialist, having an industry certification, such as the Certified Professional Coder (CPC®) credential from the AAPC, can help you Stand as a candidate for the job. in the field
While work experience and other qualification requirements are required for full CPC certification, those who pass the certification exam but do not have the required experience may be designated a CPC Apprentice (CPC-A). By providing proof of two years of on-the-job experience or 80 contact hours and one year of experience in a coding preparation course, CPC students may receive full CPC status.
The BLS reports that the median salary for a medical secretary, which falls under medical billers and coders, was $37,450 a year in 2021. That means half of medical billing and coding professionals make more than this amount and half make less.
The top 10% in this segment earned more than $63,100 and may reflect the salary levels of those with more work experience. The bottom 10% of earners in this field (the lowest quintile) make an average of $29,040 and $13.96 an hour, which may reflect work experience that is close to entry level. UMA graduates in the 2021-2022 cohort of medical billing and coding programs reported to UMA that they earned an average hourly wage that was close to or slightly above the BLS lowest level.
Medical Coding And Billing Career Guide
As you gain experience in the field you can earn more, especially if you move into senior or supervisory roles.
A medical billing and coding specialist needs good organizational skills. If you are a detail-oriented professional with the ability to manage time well and handle multiple projects well, a medical billing and coding job may be a good fit for you.
Candidates must also be comfortable in an office setting, as the job requires a lot of time in front of a computer screen and working with patient files. It is important to have a good understanding of medical terminology, or at least be interested in learning it. Workers in this field will also need to stay up-to-date with changes in procedures and coding guidelines, so an interest in continuing education is also a good quality for this role.
If this description sounds like you, then training for a medical billing and coding specialist position may be the perfect career choice.
Amazon.com: Medical Billing & Coding Fd, 2e (for Dummies (career/education)): 9781118982549: Smiley, Karen: Books
Billing and coding opportunities may be available to those without formal training or experience, but some medical offices may prefer experience or certification (or in some cases, both) as a billing and coding specialist. Earning a diploma or degree in medical billing and coding can help you gain the knowledge you need
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