Medical
Billing and Coding is an administrative job. Some refer to it as clerical work.
It is true that it deals mostly with tasks performed in the collections office
of hospitals and clinics however, since it is closely allied to the health care
industry, performing medical billing and coding requires specialized knowledge
of the medical field.
Unlike
nurse and medical assistants who are required to assist in the clinical
process, medical billers will not spend their working hours helping in the
clinical processes but instead using their theoretical knowledge of medicine in
properly identifying insured patients and then categorizing services provided
by the hospital and rendered by doctors to the patients.
The next
step after categorizing the services is then preparing the medical insurance
reimbursement claims form and submitting the claim to the appropriate health
insurance company for verification and settlement.
The medical
examiner of the insurance company will validate the claim and will then either
approve the medical insurance claim for settlement or reject the claim.
Through all
these events, the medical biller and coder should be on top of the situation
and able to monitor settlements and rejections, tracing them back to the
originating claim and patient’s record.
The process
looks simple as I described it but in reality, to function well in medical
billing and coding you will need the following critical skills:
Human
anatomy, physiology and diseases – you are required to understand the body and
the different systems in the body. You are also required to understand diseases
and which part of the body it affects. This is critical in medical billing and
coding.
Health
Insurance and Reimbursement process – you must know the entire health insurance
system by hearth and must have the
capacity to work under a little pressure. You will be dealing and billing and
reimbursement, it involves money and the health care professionals depend on
you to keep them paid and ready to perform proper service.
CPT and
ICD-9-CM databases – you don’t have to memorize each and every code since there
are software that you can use for coding purposes but you must be very familiar
with these two coding databases to be able to function well as a medical biller
and coder.
Medical
language and terminologies – you must be adept in medical terminologies,
abbreviation and the medical slang. Without a proper medical communication
skill you will not fit as a medical biller and coder.
These are
the critical information you must know before you can become a medical biller.
I hope you learned a lot from this post. Good luck and I wish you and your
dreams well.
