A certified medical billing/coder specialist is a skilled medical worker who functions in an office-based setting to interpret official medical records into codes which can be submitted to insurance companies for payment. The certified medical billing/coder specialist must be skilled in understanding medical terminology and searching the medical provider's documentation to identify all diagnoses, conditions, reasons for treatment, services and procedures recorded, and to assign the appropriate billing code to each. The codes determine the amount that the physician is paid for his or her services. The codes are contained in the medical records coder "bibles," the ICD-9 and CPT-4 books. Working as a certified medical billing/coder specialist requires a strong background not only in medical terminology, but also in anatomy and physiology, pharmacology, computer and typing skills, billing, and accounting. Certified medical billing/coder specialist students also complete a hands-on practicum prior to graduating. Certified medical billing/coder specialist programs are offered as diploma or degree programs. Upon graduation, the coder must take and pass a national certification exam. Certified medical billing/coder specialists work in a variety of settings, including hospitals, outpatient and inpatient clinics, surgical centers, and dental offices. Any place that provides medical services requires the services of a certified medical billing/coder specialist. Certified medical billing/coder specialists work in conjunction with physicians and other medical providers and, in addition to coding services, provide education to providers regarding medical record requirements and conduct chart reviews for completeness. Certified medical billing/coder specialists have the ability to make their own schedule, and with telecommuting can even work at home.
Certified Medical Billing/Coding Specialist Tasks
- Organize and verify patient records, bills, and statements.
- Code patients' diagnoses and requests payment from insurance companies or individuals.
- Record and process patient data including treatment records, insurance information, bills, and payments.
- Set-up payment plans for patients.