New Year, New Career: Getting Started in Medical Coding and Billing

By admin / February 4, 2019

If you’re looking for new opportunities, medical billing and coding are one of the many growing healthcare jobs you can enter. It’s also an opportunity that you can start with less cost to get the required education.

The medical billing and coding industry shows a 13% increase over the next several years. This is a faster growth rate than many industries. 

So, what is medical coding and billing? And, how do you get started with this new opportunity? The job requires specialized knowledge and certification, but you can get started quickly.

What is Medical Billing and Coding?

Medical billing and coding is a process that allows medical professionals to seek reimbursement for diagnosis, treatments, and equipment used during a patient visit. Billers and coders can find work in many places

  • Hospitals
  • Clinics
  • Physician’s offices
  • Insurance companies

Any place that requires coding procedures have a need for medical billing and coding professionals. They code patient’s information to send bills to insurance companies and process claims. 

The medical billing and coding job description require an understanding of insurance companies, the claim and appeal process, and the codes involved.

The Medical Coder

A medical coder assigns standard codes based on patient notes. These are universal codes specified for each diagnosis and procedure as well as the supplies used.

The codes are standard to help simplify the insurance claim process. These codes also help track disease patterns so medical professionals can plan for outbreaks.

The Medical Biller

A medical biller submits the claims to insurance companies. They also take care of follow-up for appeals and patient billing. 

Medical billers need an understanding of the insurance claims process. They also need an understanding of the codes used.

Getting Started in Medical Coding and Billing

To get started as a medical coder and biller, you must take a certification exam. A certified coding and billing specialist can make an average of $39,000 starting out. Management can make up to $70,000 though.

It’s possible to take the exam without going through an education program, but the opportunities for getting a job are better with an Associate’s degree.

Certification Program

There are many certification programs available to get started. You can even participate in an online program. Schools, such as the Ultimate Medical Academy, allow opportunities for both on campus and online programs.

The programs teach everything you need to pass the certification exam. This includes the claims processes, the new standards, and the codes required.

Required Codes

There are three major coding systems needed for the billing and coding process. These codes make it easier to share patient information with insurance companies, other healthcare clinics, and other medical professionals.

The standards for the different codes change occasionally, so it’s important to keep up with new codes that come up based on new procedures and technologies. This is important as the codes are essential to get proper reimbursement.

1. International Statistical Classification of Diseases (ICD-10)

The ICD-10 codes were created by the World Health Organization. They are also managed by the National Center for Health Statistics.

The ICD-10 codes are specific to diagnoses. These are the codes used to bill for specific diseases. These codes are also used to keep up with disease patterns.

2. Current Procedural Terminology (CPT) Codes

The CPT codes are managed by the American Medical Association. These codes help identify the different procedures used to treat patients. 

These codes are primarily used to keep up with insurance and patient billing processes. It’s important to understand the specific procedure codes to ensure proper reimbursement.

3. Healthcare Common Procedure Coding System (HCPCS)

The HCPCS codes are managed by the Centers for Medicare and Medicaid Services. These codes are specific to devices and supplies.

This includes any supplies, including bandages, swabs, and other common supplies. This also includes any medical devices such as scans.

Insurance Requirements

Medical billing and coding programs also teach you proper procedures for filing insurance claims. The codes are only the first step. 

To file properly, it’s important to know the different insurance companies you’ll work with. You also learn the proper process for submitting the claims and the appeals process if necessary.

Medical Terminology

Certification programs also teach you the necessary medical terminology to help with the coding and filing process. There are a lot of terms specific to the medical field that you’ll need to understand to do the job properly.

These programs help you learn how to memorize the needed terminology. The program will also teach you how to analyze the terms for the correct codes.

The Certification Exam

Once you complete the program, either online or onsite, you’re ready to sit for the certification exam. The exam analyzes your understanding of:

  • Terminology
  • Procedures
  • Codes
  • Insurance procedures
  • Management

The exam tests your ability to apply the correct codes and procedures. This is done with 150 multiple choice questions. The exam allows you to use the necessary manuals, though the test is easier if you know where to look.

You can sit for the exam without the certification program, but this will require an apprenticeship before getting full certification. Certification requires two years of experience through work or a program.

Medical Biller and Coder Opportunities

When you get a medical billing and coding certification, you have many opportunities to get started in the industry. A certification program will also help in seeking opportunities to get started.

These opportunities are open in most medical clinics or insurance companies. There are even opportunities to work from home in certain situations. Going through an accredited program will help you find the best opportunity for you.

More Tips to Better Your Situation

Getting a medical coding and billing certification is a great opportunity to better your situation with a stable job in a growing field. This isn’t the only opportunity to help your situation though.

If you’re looking for advice and tips for work, travel, or other lifestyle choices, we have the resources you need. Check out our lifestyle articles to learn more.

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