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Medical Billing and Coding Job Roles

What are medical billing specialists’ job roles?

Medical billing specialists handle insurance company billing for hospital and doctor’s services.  They work to organize and maintain the often complicated billing associated with medical diagnosis and procedures.  The roll of a medical billing professional is vital to the efficient management of any medical facility.  They use specialized classification software to assign patients to one of several hundred diagnosis-related groups (DRGs).  This DRG classification determines what part of the cost of a patient’s diagnosis and treatment will be covered by their insurance.  The work they do makes sure medical staff at hospitals or other medical facilities can focus on treating the patient without being burdened with the task of handling insurance company billing.

What are the job roles of medical coding specialists?

Medical coding uses one of a few universal medical classification systems to provide every disease, injury, medical diagnosis, and treatment its own specific alphanumeric code. 

How are the fields of medical coding and medical billing inter-related?

Although medical billing and medical coding involve the use of different skills, the two professions are closely interrelated.  These two specialties both fall under the same technical field of Medical Records and Health Information.  Billing and coding specialists both work in the administrative offices of hospitals and private practices, and both are vital to the efficient management of these medical facilities.  The two professions are so closely related that getting medical billing and coding training is fast becoming the norm.  The most popular online programs are comprehensive and include all the training necessary to begin a career that involves both billing and coding work.  This, in effect, doubles the specialist’s marketable skills making them more competitive in the job market as well as making them that much more of an asset to their employer.

Although medical coding skills can be used in various applications like tracking the occurrence of certain cancers in a region or researching the mortality rates of cancer sufferers, it is most often used in direct conjunction with medical insurance company billing.  The information that medical billing specialists receive to process has in most cases already been translated to alphanumeric code using one of the medical classification systems to assign patients to one of hundreds of diagnosis-related groups (DRGs).  The DRG assigned to the patient is ultimately what determines how much of the cost of their diagnosis and treatment will be covered by their insurance.  This makes a specialist who knows both billing and coding far more efficient since they understand both the classification systems and the insurance company billing procedures.

Are there specialized medical coding fields?

The field of medical coding is as vast as the field of medicine itself.  Much like physicians who specialize in specific disease pathologies and ailments, medical coders too can specialize.  Medical billing and coding certification for medical specialties is available through a number of national organizations:  The Board of Medical Specialty Coding (BMSC), The Professional Association of Healthcare Coding Specialists (PAHCS), and The American Academy of Professional Coders (AAPC).  Earning these specialty certificates would add a credentialed title that would follow the earner’s name much like those who’ve earned doctorates have PhD behind their names.

Medical Billing & Coding Schools