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What Is a Medical Billing and Coding Specialist?

Healthcare billing and coding is a career you’ve likely heard a lot of lately. Medical billing and coding specialists work in the healthcare field and are responsible for converting medical procedures and diagnoses into codes that can be used for billing purposes. If you are interested in working in the healthcare field but don’t wish to work on the clinical side of things, pursuing a career in medical billing and coding might be a good fit for you. If this sounds like what you are looking for, consider checking into local vocational schools that offer career training in medical billing and coding to get you on the path to your new career.

If you’re interested in becoming a medical coding and billing specialist, there are some important things you should understand first. Like all careers, being a medical biller and coder has specific expectations and skills associated with it. Learning those skills is an important step to take on your journey to success.

We’re going to go over all the basics about what being a medical biller and coder really means to help you make your choice.

What Is a Medical Billing and Coding Specialist?

Specialists in medical coding and billing play an integral role in the healthcare system. Their job is to make sure that healthcare professionals, such as physicians, are paid for their work. That’s not where the description starts and ends, however, as there’s more to the career below the surface.

Technically speaking, medical billing and medical coding are two separate careers that have become merged over the years due to their similarities. To understand what being a medical biller and coder really entails, you first have to understand what each separate job is and why they’re often combined.

The Medical Coder

Medical coding,, is a job that could be described as similar to translating. Medical coders are tasked with converting the important healthcare information and patient data into an alphanumeric code. Being able to do this means that a medical coder must be knowledgeable about medical terminology, anatomy, and physiology and understand the various medical codes, and there are a lot of them.

There are codes for the patient’s specific emergency as well as for the symptoms of that emergency, codes for the treatments prescribed by the doctors, and even codes for specific healthcare devices. These codes are used because they’re like a universal language for a variety  of healthcare professionals and healthcare facilities to understand. So, the medical coder plays an important role in cataloging this information for the purposes of record keeping and billing.

The Medical Biller

Medical billing doesn’t require as much explanation as coding. Healthcare billing specialists are responsible for managing patient billing information, sending out the healthcare bills to the patient, and submitting insurance claims  to patient providers. A medical biller is also responsible for following up on insurance claims and denials as the funds that billers are responsible for collecting are what pays the bills of the medical facility they work for.  Medical billers typically have a solid understanding of insurance policies, healthcare regulations and guidelines.

Why Combine the Jobs?

Medical billing and medical coding are different fields. However, they’re inherently linked, and ultimately both jobs are working toward the same goal. It’s only natural that you’ll often hear them as one job rather than separate ones.

Medical billing requires the use of the codes as recorded by a coder. These codes ultimately determine how much each service costs and what should be billed. If the medical biller is also the medical coder, then it helps that the person interpreting the codes is also the one writing them down in the first place, which streamlines the process. This means that the medical biller and coder tend to be the same person entering and translating data, as well as the person who uses that data to write the bills.

Those who work in medical billing and coding are typically expected to review patient data, assign the necessary codes, double-check the data for accuracy, and then create, send, and keep up with  the claims sent out to insurance companies and the bills sent out to patients.

Becoming a Medical Billing and Coding Specialist

Before we began, you were likely asking, “what is a medical billing and coding specialist?” Now that we’ve answered the first query, we can explain how you can prepare for such a job in the first place.

Some employers may be looking for a postsecondary certificate or diploma and a professional certification from applicants. There are several certifications that an aspiring healthcare billing specialist could earn, and there are also several important skills that employers may demand, such as analysis, integrity, and interpersonal skills.

At South Texas Vo-Tech Institute (STVT), we provide hands-on training for a variety of trades, including medical billing and coding. You can learn to prepare for common tasks you might encounter as a medical biller and coder by enrolling in our Medical Billing and Coding diploma program. Invest in yourself and explore what STVT has to offer!