In today’s giant health care industry, it requires medical billing and coding professionals to process expenses from insurance providers and patients. These professionals work with patients, insurance providers, individuals in many other healthcare careers and others to confirm expense is received for services delivered. About one-third of all billing personnel are working in the Health care industry, where medical coding is a fundamental part of the billing procedure. Training for jobs in medical billing and coding consists of coursework that tells how universal codes are used to designate whether the service offered in a doctor’s office, an outpatient medical center or in the critical care unit of a hospital. Another set of codes will point out about the doctor’s diagnosis and medication, if any, was prescribed for therapeutic purposes. Additional codes are often used to indicate the sort of insurance a patient has and what amount the patient have to pay from his pocket.
Most patient accounts are maintained electronically nowadays, which has made the accounts payable department in doctor’s offices and hospitals more efficient. Health care professionals such as physicians, registered nurses and radiology technicians enter the suitable codes into a database at the time of a patient’s visit. Peoples in medical billing and coding jobs then take the information and bill the appropriate parties. They check with a patient’s insurance provider to make sure it will cover procedures or services rendered and at what percentage of the total cost. Medical coders need to be familiar with health care databases that are designed to hold the medical coding system. Because they work with patient records that are protected under HIPAA laws, certain safety measures must be taken to uphold confidentiality. Individuals in this occupation work closely with informatics specialists – information technology personnel who work with health care records – concerning database security matters.
In today’s ever growing medical industry, many recruiters often ask for following characteristics in job description of the candidates in their circular:
- Proficiency in reviewing and assigning exact medical codes for diagnoses, procedures, and services performed by doctors and other qualified health care providers
- Skilled in a wide range of services, including assessment and management, anesthesia, surgical services, medical technology, radiology, pathology and medicine
- A sound knowledge of medical coding policy and regulations including compliance and compensation – allowing a CPC to better handle matters such as medical necessity, claims denials, charge capture and other health related issues.
- knowing how to integrate medical coding and compensation rule changes into a practice’s compensation processes
- Have basic knowledge of anatomy, physiology, microbiology and other medical terminologies necessary to properly code provider diagnosis and other patient focused services.
Whereas three basic criteria remains the first selection choice for most of the healthcare companies, recruiting agencies or hospitals:
- Academic credentials: Minimum 1 year certificate or 2 year associate degree.
- Professional certification: AAPC, AIHMA or such type of well known certification.
- Experience: hand-on-hand professional experience as a medical coder in a healthcare setting.