Are you thinking about starting a career as a medical billing and coding specialist? Before you pay for tuition, you might spend some time to understand exactly what duties you’ll perform every day in this role.
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A doctor and his medical staff will diagnose a patient with a medical condition based on a set of criteria that fits a particular diagnosis. That diagnosis is then put into the office software. The software assigns a code as determined by HIPAA (Health Insurance Portability and Privacy Act) and the ICD (International Classification of Diseases) in the patient’s record. This is where you, as the medical billing and coding specialist, needs to understand the codes and review the record, making sure the right code has been assigned correctly not only for proper care but for billing to insurance companies and the patient.
It’s here you play a vital role. You are the connection between a medical office, the patient, and the patient’s insurance provider.
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Accuracy in Billing
If the claim is submitted and it is incorrect, you will be required to act as liaison between your office and the patient’s insurance company to correct any problems and resubmit.
As a medical billing and coding specialist, you are also responsible for the following:
- Preparing and sending invoices for payment.
- Following up with patients and their insurance companies regarding outstanding bills.
- Tracking payments.
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Working With Insurance Companies
One of the most important roles for a medical billing and coding specialist is billing and reimbursement. Working with insurance companies can be tricky. Understanding the intricacies of how to do things will make your job, and your success, much easier.
Codes. Using the correct codes to bill insurance providers will reduce the number of rejected claims. Part of your job will also be to correct and resubmit rejected claims.
Reading and analyzing patient charts. You will need to understand what diagnosis and course of action the doctor or medical staff has given to a patient. Then you shorthand the information into the patient’s record.
Communication. Here you will have to interact with the physician and medical staff to verify the accuracy of a claim before submitting to the insurance company.
Determining the correct codes for patient records. If you apply the wrong code, this may flag the record for the wrong care, but also bill the patient and the insurance company for the wrong diagnosis and medical course of action. This could be a huge financial discrepancy, opening the claim up for rejection.
Medical Billing and Coding at Bryan University
If this seems like the perfect career path for you, then we encourage you to make an appointment to speak with one of our education enrollment professionals. Being a medical billing and coding specialist can be an incredibly rewarding profession. Call Bryan University toll-free at 1-855-862-0755 or enroll now to find out more information!