Job Duties of a Medical Biller and Coder

Medical billers and coders are healthcare professionals in charge of processing patient information such as treatment records and also the related insurance information. In this regard, they are tasked with billing and coding a patient’s diagnosis in respect to a request for payments from the insurance company. Every service performed at an healthcare facility requires a code assigned to its bill. Therefore, this article narrows down to the medical billing and coding job duties.

Medical billing and coding job duties

Translating patient’s data into an alphanumeric medical code. Medical coders provide appropriate coding on all the patient’s information which include basic details, patient’s medical history, diagnosis, carried tests and even treatment. On this note, they should ensure that the coding is clear and precise.

Similarly, coders are required to know the different coding systems. There are usually three coding sets which include HCPS, CPT and ICD-9/10. By acquainting themselves with these sets, they are rest assured they can cope with the ever transitioning medical services.

Medical billers and their salaries are vested with the ability to ensure everyone is billed correctly. First, they use coded medical records to create invoices submit them to the patient and their respective insurance companies. All patients are required to provide the details of their insurance companies, for use in this case.

They are also tasked with preparing the patient’s statements. Right from the consultation to the treatment bills. Also, for updated records purposes, medical billers are required to review the patient’s statements.

Medical billers also make a follow up with the insurance companies. This is in a quest to see whether the claim has been accepted or denied. If accepted, the billers process payments from the insurance firms. But if denied, it is still the duty of medical billers to investigate the rejected claim and find the reason why denial was issued.

In other cases, there can be fraud among the insurance companies. Hence, medical billers and coders are required to investigate the said insurance companies and report any cases of such malpractices.

Another duty of medical billing professionals is to ensure that all the healthcare facilities are reimbursed for all procedures, hence ensuring a smooth workflow in the healthcare services.

Furthermore, they are responsible for answering all patient or insurance telephone inquiries that pertains to the assigned accounts.

Finally, through the work of creating efficient coded invoices and detailed billing records, it is evident that these specialists ensure that the business side of healthcare does not compromise the vital medical care that their patients need. The healthcare facilities cannot work well without the services of medical billers and coders.

Nsromain Institute