What Does a Medical Billing and Coding Specialist Do?

Today, the financial health of any medical practice is closely tied to the performance of its billing office. Increased demands on providers, coupled with decreased insurance reimbursement, has led many medical offices to invest in skilled medical billing and coding specialists. These professionals, who have an in-depth knowledge of medical insurance and the claims and appeals process, help ensure healthcare providers are accurately and efficiently reimbursed for the services they perform.

The healthcare industry uses a coding system to be sure the treatments and procedures patients receive match insurance billing and government standards. Medical billing and coding professionals provide a key step in the medical billing process, translating a healthcare provider’s diagnosis and treatment into the specific codes in order to be submitted as a claim.

To do their jobs effectively, medical billers and coders need to understand how the medical insurance system works. They must know how to code the information correctly to expedite claims, and what to do if a claim is denied. Duties include reviewing records, calculating changes to patient procedures and services, and preparing itemized statements and submitting claims to third party payees. Medical billing and medical coding certifications require that students learn federal coding standards in CPT-4 (Current Procedure Terminology standardized by the American Medical Association) as well as ICD-9 (Coding standards for diseases and disorders issued by the Centers for Medicare and Medicaid Services).

With their specialized knowledge, skills, and efficiency, medical billing and coding professionals are valued members of every healthcare team. In fact, as the aging population requires more medical tests, treatments, and procedures, the employment of medical records and health information technicians is projected to grow 8% from 2019 to 2029, much faster than the average for all occupations.

Interested in a career as a medical billing and coding professional? Dorson Vocational Training Institute’s Certified Medical Billing & Coding Specialist online course is comprised of a series of six modules and students will complete an externship in a doctor’s office, clinic, hospital, or laboratory. You will gain an understanding of medical insurance and completing medical insurance forms, the roles of a medical office team, and the principles of procedure and diagnosis coding. We are fully licensed by the State of New Jersey and our courses are certified by The National Health Association.

To learn more about our Certified Medical Billing & Coding Specialist online course or other healthcare classes and training programs, call us at 973-676-6300 or contact us. We’re happy to answer all of your questions!