What is Medical Billing and Coding

Medical billing and coding is a complex job that is full of responsibility and understanding of various medical health processes as well as a sound knowledge of insurance rules and regulations. According to the American Hospital Association, about 18% of the medical billing and coding positions are yet to be filled, due to lack of qualified staff.

What is Medical Billing and Coding
After being a part of the health care industry, it has been my experience that medical billing and coding professions secure a job very easily. This is due to the fact that their qualifications, training, skills and experience gives them an upper hand against a candidate who lacks these finer qualities.

Medical coding is a system that helps maintain the records of each individual patients in a way, that is a universally recognized coding system (ICD - 9). This helps ensure that the information stored is in compliance with the federal regulations and the requirements laid down by insurance companies.

Medical billing is a sub-specialty of medical coding that ensures a patient is billed correctly. It also involves interaction with insurance companies apart from patients. The medical billing department makes sure all the invoices are paid on time and in an orderly fashion. The medical billing and coding specialist needs to have proper knowledge of the coding related to different medical invoices and patient information.

Job Description of a Medical Biller
Basic requirement includes doing two different jobs, but simultaneously. The medical biller/coder is a person who enjoys working within the hospital environment, has knowledge regarding various medical processes and terms. But a specialist does not have a medical background. Instead the specialist is a part of the non-medical team, that is, part of the administration.

A medical billing and coding job specialist needs to collect, organize and carry out data entry of all the patients records, bills, statements and make sure they are error free. They need to understand the codes mentioned by the doctors related to treatments and diagnosis. Then, these notes need to be translated into a format that will be understood by others in the health care setup. They also need to correspond with insurance companies who come for verification and additional information for payment of a patient. If the insurance company does not cover the patient, they need to forward the bill to the patient for payment.

Medical billing specialists have to make sure that a patient is billed correctly and gets them to pay the bills on time. They also need to speak to people from the health insurance company on the phone and analyze the invoices as well as data for billing.

Medical coding specialist on the other hand have nothing to do with patients or the insurance company. Their job requires them to analyze and code data. There are codes for each and every procedure and the medical coding specialist needs to ensure each file is properly coded and sent for billing. The medical billing specialist and medical coding specialist therefore, need to work as a team to get the bills and invoices paid in a correct manner.

In a small hospital setup or day care center or a nursing home, one person can double up as a medical biller as well as a coder. Most of the time, these hospitals tend to outsource such jobs to an external billing agency.

The job descriptionof a medical biller includes working on 40 hour work week shifts or even part-time. This depends on the medical billing agency or the hospital you work for. Some agencies also offer extra pay to those who give in extra hours on the job. These specialists work in a hospital or an agency office away from the health care facility.

Educational Qualifications
A medical billing and coding specialist needs to at least have a high school diploma. Many employers seek someone with a bachelor's degree in accounting, business administration and such related fields. There are many vocational schools and colleges that provide training in medical terminology, medical billing software, medical documentation evaluation and government programs. This helps a specialist add to his on-job experience and reduce the training cost for the employers who need to start from scratch with an untrained professional.

Salary Range
The salary of a medical biller/coder is based on many factors. A person seeking a job in an area with high cost of living and thriving local economy, will earn higher than someone else. Also, working in a large hospital, private establishment, etc. plays a part on the salary. Your educational qualifications, experience, etc. will help you earn a higher salary. Thus, predicting the exact salary is a bit difficult. However, according to the National Human Resources data, medical billing and coding salary range is about USD 35,999 to USD 44,562 annually (as per research done in 2008). There must have been a significant rise in the salary at present, as that was an estimate from 2008. So, the starting salary of medical biller/coder is about USD 33,370 especially for those who are just starting out in this field.

It is not necessary that one needs to get a job in a hospital as medical billing and coding specialist. One can even seek jobs in insurance companies, nursing homes, outpatient care centers, doctor's offices, rehabilitation centers, home health care services as well as billing agencies. This occupation is said to be one of the best careers for 2010 and beyond. If you too are thinking about it, you should find out more about the schools offering training and the possible jobs available in your area.