Medical coding and billing are two careers for people who want to get into healthcare but are not interested in positions with a heavy emphasis on patient interaction. Both are also careers for detail-oriented people. You’ll be happy to know that ProTrain offers certification courses for both.
Note that medical coding and billing are two distinct and separate functions. Coders and billers may interact with one another in the work environment, but their responsibilities are separate. Therefore, their certifications are distinct as well.
The Basics of Medical Coding
Medical coding is the task of translating medical procedures, diagnoses, etc. into standardized codes for billing. The codes are understood and utilized by virtually every entity in healthcare. This includes hospitals and private practices, insurance companies, public health clinics, and government agencies.
The medical coder’s primary responsibility is to capture the entirety of a medical encounter in codes. The codes function as a medical shorthand for billing and recordkeeping purposes. Coders should have a sufficient knowledge of the major code sets, including CPT and ICD-10.
Certification demonstrates that a medical coder has a thorough understanding of the tasks at hand. It shows a basic understanding of medical terminology pertaining to human biology, treatment options, pharmacological terms, and so forth.
The Basics of Medical Billing
Medical billers take the information generated by coders and translate it into bills. Those bills are submitted to payers by way of claims. In addition, medical billers keep track of claim status and manage other matters pertaining to getting paid.
Medical billers do interact with patients to some degree. In some instances, they are required to verify patient information in-person. They might also need to contact patients to discuss denied claims. Managing patient accounts and collecting payments can also be within the scope of a medical biller’s daily tasks.
Attention to Detail Is Critical
Attention to detail is critical to both careers. From the coder’s standpoint, there are tens of thousands of medical codes to work with. Coders are not expected to memorize them all, but they are expected to know their way around the resources they utilize to look up codes.
Choosing the right codes virtually guarantees claims will be paid. Choosing the wrong codes often leads to claim denial. Furthermore, payers tend to hold fast to deadlines for submitting claims. Coders need to do what they do in a timely manner while still maintaining accuracy.
Details are equally important to medical billers, particularly where patient information is concerned. Incorrect patient information is a leading cause of medical claim denials. In addition, billers need an in-depth understanding of the medical billing software they used to do their jobs. Software can be rather detailed in terms of granular functions.
Solid Training Is a Big Help
We encourage anyone considering a career in medical coding or billing to get the appropriate training and certifications. Although there is no federal mandate that medical coders and billers be certified, growing numbers of employers are requiring it. And even among those that do not, solid training sets up a biller or coder for a long and successful career.
If you already work as a medical coder or biller, consider additional certifications that could advance your career. Earning new certificates proves your commitment to being the best you can be. It also paves the way for higher pay, advancement opportunities, and more.
ProTrain has the courses you’ve been looking for. Take a look at all our options for medical coders and billers. We offer self-paced, online learning that will prepare you to work in the real world.
